Total and subtotal replacement of the common bile duct: effect of transhepatic silicone tube stenting.

The effect of silicone tube stenting on the outcome of total and subtotal replacement of the bile duct with autologous vein was investigated in experiments performed in pigs. All but one of the unstented animals developed dense strictures of the extrahepatic ductal system. This complication was abolished by the use of silicone stents passed transhepatically. The vein autografts in the stented animals underwent progressive shortening with elongation of the distal common bile duct so that beyond four months only one suture line was encountered, and no recognisable venous element was detectable on histological examination. Apart from minor dilatation of the intrahepatic biliary tree encountered in some animals, all the surviving stented animals progressed well and had normal serial liver function tests.