Novel reconstruction of the extrahepatic biliary tree with a biosynthetic absorbable graft

Peter Nau; James Liu; E. Christopher Ellison; Jeffrey W Hazey; Matthew Henn; Peter Muscarella; Vimal K Narula; W. Scott Melvin

doi:10.1111/j.1477-2574.2011.00337.x

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Novel reconstruction of the extrahepatic biliary tree with a biosynthetic absorbable graft

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Novel reconstruction of the extrahepatic biliary tree with a biosynthetic absorbable graft

Peter Nau, James Liu, E. Christopher Ellison, Jeffrey W Hazey, Matthew Henn, Peter Muscarella, Vimal K Narula and W. Scott Melvin

HPB (Oxford, England), Vol.13(8), pp.573-578

08/2011

DOI: 10.1111/j.1477-2574.2011.00337.x

PMCID: PMC3163280

PMID: 21762301

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Abstract

The reference standard technique for the reconstruction of the extrahepatic biliary tree is Roux-en-Y hepaticojejunostomy. This procedure is not without complications and may not be feasible in some patients. This project sought to evaluate a novel approach for repairing common bile duct injuries with a biosynthetic graft. This allows for the reconstruction of the anatomy without necessitating an intestinal bypass. Study subjects were 11 mongrel hounds. Utilizing an open approach, the common bile duct was transected in each animal. A 1-cm graft of a synthetic bioabsorbable prosthesis was interposed over a 5-Fr pancreatic stent and sewn in place as an interposition tube graft with absorbable sutures. Intraoperative cholangiograms and monthly liver function tests were completed. Animals were killed at 6, 7, 8, 10 and 12 months. The first five animals were killed early in the process of protocol development. One animal developed obstructive symptoms and was killed on postoperative day 14. The next five animals were longterm survivors without evidence of clinically significant graft stenosis. Mean alkaline phosphatase and total bilirubin were normal, at 140U/l and 0.2mg/dl, respectively. Histology showed the complete replacement of the graft with native tissue at 6 months. Biliary reconstruction using a synthetic bioabsorbable prosthetic as an interposition tube graft is feasible based on initial results. Biliary reconstruction using a synthetic bioabsorbable prosthetic is possible

basic science < biliary

basic science < liver

Details

Title: Subtitle: Novel reconstruction of the extrahepatic biliary tree with a biosynthetic absorbable graft
Creators: Peter Nau - Department of Surgery, Ohio State University School of Medicine and Public Health, Columbus, OH, USA
James Liu - Department of Pathology, Ohio State University School of Medicine and Public Health, Columbus, OH, USA
E. Christopher Ellison - Department of Surgery, Ohio State University School of Medicine and Public Health, Columbus, OH, USA
Jeffrey W Hazey - Department of Surgery, Ohio State University School of Medicine and Public Health, Columbus, OH, USA
Matthew Henn - Department of Surgery, Ohio State University School of Medicine and Public Health, Columbus, OH, USA
Peter Muscarella - Department of Surgery, Ohio State University School of Medicine and Public Health, Columbus, OH, USA
Vimal K Narula - Department of Surgery, Ohio State University School of Medicine and Public Health, Columbus, OH, USA
W. Scott Melvin - Department of Surgery, Ohio State University School of Medicine and Public Health, Columbus, OH, USA
Resource Type: Journal article
Publication Details: HPB (Oxford, England), Vol.13(8), pp.573-578
Publisher: Elsevier Ltd
DOI: 10.1111/j.1477-2574.2011.00337.x
PMID: 21762301
PMCID: PMC3163280
ISSN: 1365-182X
eISSN: 1477-2574
Language: English
Date published: 08/2011
Academic Unit: Surgery
Record Identifier: 9984051735202771

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