Bile Duct Replacement Using Bovine Pericardial Patch Graft: an Experimental Study

Choi, Woo Sik; Yoon, Ki Young; Park, Jong Woo; Lee, Sang Ho; Lee, Chung Han; Gagner, Michel

Abstract

PURPOSE: The repair of common bile duct injuries is a complex procedure that has a significant rate of postoperative morbidity and mortality. The aim of this study was to demonstrate the usefulness of the bovine pericardial patch (BPP) graft for replacement of the bile duct.
METHODS
In this study, BPP with Indermil glue was used to evaluate the effectiveness, morphological changes, early complications and changes of BPP's character. Four male pigs weighing 30~40 kg each were used in the study. We attached a BPP on the small size defected common bile duct (CBD) surface of one pig with using Indermil glue. Another pig's segment of the CBD was resected and the biliary tract was replaced by a tube formed from BPP. After 2 weeks, these animals were sacrificed and we analyzed the patch attachment, the cholangiography and morphological changes.
RESULTS
We made a tube-like form from BPP with Indermil; we put it into saline (NaCl 0.9%), gastric juices and bile for 2 weeks to test the changes of the material and the strength of the attachment. Nothing changed, and the attachment remained secure. After 2 weeks these animal were sacrificed and the patch attachment was evaluated by cholangiography and the morphological changes. One significant adhesion with fibrosis in surrounding tissue was noted with obstruction of the CBD.
CONCLUSION
These observations suggest that BPP with Indermil glue may well be an acceptable membrane in CBD replacement.