Repair of bile duct defect with full‐thickness vascularized jejunal patch

Bengtsson, Henrik J. O.; Broomé, A; Rimér, U

doi:10.1007/bf01655323

Cited by 8 publications

(6 citation statements)

References 16 publications

(30 reference statements)

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“…No stenosis was found in any of our 5 patients. In accordance with the results of others, we observed a dilatation of the patch [4], Based on our experimental data, this enlargement occurs as a consequence of tension at the pedicle and not as a result of intrahepatic bile duct pressure, as suggested by Bengtsson et al [4], The maintenance of peristalsis of the patch is due to innervation of the patch which permits a free bile flow [5]. Under experimental conditions we did not note any alterations in the small bowel mucosa 14 months postoperatively [5].…”

Section: Discussionsupporting

confidence: 82%

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Correction of Common Bile Duct Stricture with Full-Thickness Vascularized Jejunal Patch

Böttger¹,

Heintz²

1997

Dig Surg

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Section: Discussionsupporting

confidence: 82%

“…The use of a vascularized patch obtained from the jejunum to widen a bile duct stricture has, to our knowledge, been described only in a case report and in a dog and pig model, respectively [4][5][6].…”

Section: Correction Of Common Bile Duct Stricture With Full-thicknessmentioning

confidence: 99%

Correction of Common Bile Duct Stricture with Full-Thickness Vascularized Jejunal Patch

Böttger¹,

Heintz²

1997

Dig Surg

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“…Dieser hfitte gegenfiber den bislang am hfiufigsten angewandten biliodigestiven Anastomosen den Vorteil der erhaltenen physiologischen papillfiren Passage, die einen Nahrungsreflux in das Gallenwegssystem mit nachfolgenden Cholangitiden verhindert [4,5] [3,12,17]. M a n beobachtet jedoch wie auch wir bei unserem Patienten eine Dilatation des Patches (Abb.…”

unclassified

Tierexperimentelle Untersuchungen zum gestielten D�nndarm-transplantat als partieller extrahepatischer Gallengangsersatz

Böttger

Mann²,

Pickel³

et al. 1991

Langenbecks Arch Chiv

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A pedicle graft of the jejunum can in some cases enlarge a bile duct stricture. The enlargement of the patch and its consequences on the liver function are possible problems. In an animal experiment the following questions were sought. 1) Is a partial replacement of the bile duct with a pedicle graft of small bowel possible? 2) Is there an enlargement of the patch in every case and what are the consequences on the biliary tract and on liver function. The experiments were performed on 14 minipigs over a long-term observation period of 450 days. The red and white blood cell count, the GPT, GOT, GPT, bilirubin and alkaline phosphatase and copper were checked monthly. After 2, 6 and 12 months the intra- and extrahepatic biliary tract were visualized via a PTC. After 8 months an angiography of the pedicle graft was performed. 15 months later the animals were killed and the bile duct, the graft and the liver were histologically examined. 1) With a pedicle graft of small bowel a partial replacement of the extrahepatic bile duct is possible. 2) An enlargement of the patch is seen in every case. The enlargement is a consequence of tension at the pedicle. After 15 months no morphological changes were observed at the patch nor were there any irregularities in liver function.

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“…Benigne Gallengangsstenosen sind zu 80-97 % Folge von iatrogenen Verletzungen des Gallengangs [1,2,4,5,7,14,17,19]. Diese werden in 0,2-0,5% der F/ille nach einer Cholezystektomie und in 0,1% der F/ille nach Magenresektion gefunden [1,2,5,14].…”

unclassified

“…Diese werden in 0,2-0,5% der F/ille nach einer Cholezystektomie und in 0,1% der F/ille nach Magenresektion gefunden [1,2,5,14]. Berficksichtigt man, dal3 ca.…”

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Ein gestieltes D�nndarmsegment zum zirkul�ren Ersatz des extrahepatischen Gallengangs bei erhaltener papill�rer Passage

Böttger¹,

Weber²,

Sorger

et al. 1991

Langenbecks Arch Chir

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The effect of a small bowel segment as a extra-hepatic bile duct replacement was examined in 12 pigs followed-up for a period of 420 days. No complications, either during the operation or postoperatively, were observed in any of the animals. The laboratory parameters were within normal range over the entire observation period of 420 days. After 2, 6, and 12 months there was no anastomotic stenosis in the PTC. The intrahepatic biliary tract was not dilated. There was obvious peristalsis of the small bowel transplant towards the papilla of Vater. The autopsy showed that the grafts had healed without any sign of irritation. Histologically the structure of the graft remained undisturbed. There was a clear distinction between the mucosa of the bile duct and that of the small bowel, with no sign of a chronic infection. In the graft as well as in the vascular pedicle the nerve fibres were intact. Liver biopsy showed no pathological changes. In the light of these experiments, a small bowel segment presents a very promising alternative replacement of the extrahepatic biliary tract.

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Repair of bile duct defect with full‐thickness vascularized jejunal patch

Cited by 8 publications

References 16 publications

Correction of Common Bile Duct Stricture with Full-Thickness Vascularized Jejunal Patch

Correction of Common Bile Duct Stricture with Full-Thickness Vascularized Jejunal Patch

Tierexperimentelle Untersuchungen zum gestielten D�nndarm-transplantat als partieller extrahepatischer Gallengangsersatz

Ein gestieltes D�nndarmsegment zum zirkul�ren Ersatz des extrahepatischen Gallengangs bei erhaltener papill�rer Passage

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