Bile Duct Replacement Using an Autologous Femoral Vein Graft: An Experimental Study. Preliminary Results

Capitanich, Pablo; Herrera, Javier; Iovaldi, Mario L.; Balbuena, Roque L; Casas, Gabriel; Malizia, Patricio; Bun, Maximiliano; Mezzadri, Norberto A

doi:10.1016/j.gassur.2004.09.024

Cited by 10 publications

(9 citation statements)

References 12 publications

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“…Dokmak et al 21 also demonstrated that the parietal peritoneum can be safely used as an autologous substitute for venous reconstruction in patients undergoing vascular resection during hepatopancreatobiliary surgery. Furthermore, Capitanich et al [22][23][24] reported the usefulness of using an autologous femoral vein graft for bile duct reconstruction. Hence, the investigators arrived at the idea of using the diaphragm, ligamentum teres hepatis, or other autologous materials, such as the falciform ligament, to reconstruct vessels.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of bile duct as venous graft for venous reconstruction in pancreatic surgery: An animal experimental study

Fan

Dai

et al. 2020

Vascular

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Objective Pancreatic cancer is a kind of high malignant tumor with a poor prognosis. The aim is to determine whether the dilated bile duct can be used to reconstruct the vessels. Methods An animal model of jugular vein and portal vein reconstruction was established using the bile duct. A total of 20 landrace pigs were selected to undergo jugular vein reconstruction or portal vein reconstruction using the bile duct as a patch or bridge. The patency was evaluated by color Doppler, the reconstructed segments were removed and examined macroscopically and histologically at specified intervals, and the results were compared with synthetic vessels (IMPRA straight, 10s03-19). Results The lumen was patent, although a low level thrombosis was observed when jugular or portal vein patching was used. For bridging, stenosis of the lumen was observed, and necrosis appeared when the bile duct was used for bridging, indicating that it is feasible to reconstruct the jugular vein and portal vein with a bile duct patch. However, the bridge was not feasible possibly due to loss of blood supply, and consequent necrosis and fibrosis. Conclusion The bile duct is technically feasible, but the outcomes are unsatisfactory.

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Section: Discussionmentioning

confidence: 99%

Feasibility of bile duct as venous graft for venous reconstruction in pancreatic surgery: An animal experimental study

Fan

Dai

et al. 2020

Vascular

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“…Multiple experimental trials have been reported replacing the biliary defects with a variety of materials but failed to support the usefulness of these materials. [22][23][24][25][26][27] Our new procedure utilizing IVGT interposition has the advantage of being physiologic keeping normal path of bile and keeping the sphincter of Oddi's function thus maintaining a normal anatomy without reflux. Even when performing anastomosis with the duodenum reflux is not pronounced as the size of stoma is small (<10 mm) and the stoma is designed projecting into the lateral wall of the middle of the second part of duodenum to be amenable for ERCP examination if required.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic bile duct injury repair using isolated vascularized gastric tube: early experience in two tertiary centers

Helmy

Ali

2017

Int Surg J

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INTRODUCTIONAbout 80% of BDI occur after cholecystectomy constituting a catastrophe for both the patient and the surgeon as they are associated with significant morbidity and mortality, reducing long-term survival and quality of life, and are associated with high rates of subsequent litigation.1,2 Laparoscopic cholecystectomy (LC) has largely replaced open cholecystectomy (OC) but its potential disadvantage is a 2-fold increase in BDI. Moreover, injuries after LC are more proximal, are revealed earlier, are presented by leaks more than by strictures, are repaired more frequently by nonspecialists, and more associated with lost segment and ischemia due to combined vascular injury.3 Most of BDI present as biliary stricture, external or internal fistula, and biliary peritonitis. 4 If left untreated BDI may be complicated with biliary strictures, hepatic atrophy, cholangitis and intra-hepatic lithiasis. Later, fibrosis or even secondary biliary cirrhosis and portal hypertension can develop, enhanced by prolonged biliary obstruction associated with recurrent cholangitis.5 Also there is ABSTRACT Background: Bile duct injuries (BDI) constitute a disaster for both the patient and the surgeon without satisfactory results with the classic use of roux-en-Y hepaticojejunostomy (RYHJ). The purpose of this study was to evaluate our newly introduced technique utilizing isolated vascularized gastric tube (IVGT) as an alternative for RYHJ in reconstruction of the bile duct after iatrogenic BDI with lost segment. Methods: This is a prospective study included 18 consecutive patients suffered from iatrogenic BDI with lost segment admitted to Assiut and Sohag University Hospitals, during the period from September 2013 to June 2016. Patients were subjected to operative treatment with the interposition of IVGT to bridge the lost bile duct segment. Patients were evaluated regarding demographic criteria, clinical picture, different investigations, efficacy of the use of IVGT and evaluation of post-operative complications after a mean follow-up of 2 years. Results: Eighteen patients underwent repair of BDI utilizing IVGT during the study period. Three patients (17%) suffered immediate repairs, 10 patients (55%) experienced intermediate repairs and late repairs were performed for the last 5 patients (28%). Bile leak as a specific early morbidity was present in 3 patients (17%) with upper biliary tract injury without any operative mortality. Also, there was one patient with stent obstruction relieved by stent extraction. With long-term follow-up there was not any patient of biliary stricture. Conclusions: IVGT proved to be feasible and safe for bile duct replacement and is a good alternative for biliary reconstruction being more anatomical and physiological than RYHJ.

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“…Biological materials (veins and arteries, small bowel, gallbladder, muscular tissue, skin, and so many other tissues) have been used without satisfactory outcomes (6)(7). This is also the case for the synthetic grafts or prostheses (Vitallium, Rubber, Daflon, Silastic, ePTFE) which have been tested to improve the prognosis of the surgical outcome during the past century.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of a Common Bile Duct Injury by Venous Bypass

Biglari¹,

Bussche²,

Vanlangenhove

2013

Acta Chirurgica Belgica

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Hepaticojejunostomy is the standard technique for the reconstruction of severe iatrogenic lesions of the common bile duct (CBD), although the technique itself is major surgery with a complication rate up to 30%. We report a case of a male patient with a iatrogenic complete transsection of the CBD. Due to multiple previous operations and the present inflammation a standard reconstruction technique was not possible to perform. A neo-bile duct was created using a segment of the Great Saphenous Vein (GSV) synchronously with an external biliary drainage by PTCA and biliary stenting (after 4 weeks). The stent was removed 8 months later. Cholangiography showed normal bile flow without occlusion. Blood tests normalised. We believe that using an autologous vein graft in combination with a removable or biodegradable stent is the right track for the reconstruction of the CBD in the future.

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Bile Duct Replacement Using an Autologous Femoral Vein Graft: An Experimental Study. Preliminary Results

Cited by 10 publications

References 12 publications

Feasibility of bile duct as venous graft for venous reconstruction in pancreatic surgery: An animal experimental study

Feasibility of bile duct as venous graft for venous reconstruction in pancreatic surgery: An animal experimental study

Iatrogenic bile duct injury repair using isolated vascularized gastric tube: early experience in two tertiary centers

Reconstruction of a Common Bile Duct Injury by Venous Bypass

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