Yifan Wang1, Yuelong Liang, Weijia Wang, Renan Jin, Xiujun Cai. 1. Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University, 3 East Qingchun Road, Hangzhou, 310016, People's Republic of China.
Abstract
BACKGROUND: Electrothermal injury of common bile duct is a frequent type of biliary injury. A long-term postoperative course and biliary leakage after removing T-tube are associated with external drainage. A method was developed to repair the injury with a degradable biliary stent instead of T-tube insertion. METHODS: Pigs were divided into a stent repair (SR) group (n = 18), a T-tube repair (TR) group (n = 4), and a suturing repair (SUR) group (n = 4). An electrothermal injury model was made by electric coagulation. Pigs in the SR group were further divided into five subgroups according to the observation time (2 weeks and 1, 3, 6, and 18 months). Pigs in the TR group and SUR group were observed for 6 months. Cholangiography was repeated and bilirubin level was monitored. Pigs were reoperated for further evaluation at the end of observation. RESULTS: No biliary stricture, bile leakage, or bile duct necrosis occurred in the SR group. The stent could be detected in the first 2 months. No stent migration or stent-related obstruction was observed. Three pigs in the SUR group had biliary stricture with elevated bilirubin levels. CONCLUSIONS: These results suggested that the developed method for repairing electrothermal injury of common bile duct is feasible and safe.
BACKGROUND: Electrothermal injury of common bile duct is a frequent type of biliary injury. A long-term postoperative course and biliary leakage after removing T-tube are associated with external drainage. A method was developed to repair the injury with a degradable biliary stent instead of T-tube insertion. METHODS:Pigs were divided into a stent repair (SR) group (n = 18), a T-tube repair (TR) group (n = 4), and a suturing repair (SUR) group (n = 4). An electrothermal injury model was made by electric coagulation. Pigs in the SR group were further divided into five subgroups according to the observation time (2 weeks and 1, 3, 6, and 18 months). Pigs in the TR group and SUR group were observed for 6 months. Cholangiography was repeated and bilirubin level was monitored. Pigs were reoperated for further evaluation at the end of observation. RESULTS: No biliary stricture, bile leakage, or bile duct necrosis occurred in the SR group. The stent could be detected in the first 2 months. No stent migration or stent-related obstruction was observed. Three pigs in the SUR group had biliary stricture with elevated bilirubin levels. CONCLUSIONS: These results suggested that the developed method for repairing electrothermal injury of common bile duct is feasible and safe.
Authors: Felix B Langer; Etienne Wenzl; Gerhard Prager; Andreas Salat; Johannes Miholic; Thomas Mang; Johannes Zacherl Journal: Ann Thorac Surg Date: 2005-02 Impact factor: 4.330