H. Othman, I., A. Nagy, A., A. El Nemr, A., H. El Henedy, M., A. Mostafa, S., A. Sallam, F. (2003). STENTED AUTOLOGUS VEIN GRAFT VERSUS GORE-TEX TUBE GRAFT FOR THE REPAIR OF COMMON BILE DUCT DEFECTS AN EXPERIMENTAL STUDY. test, 22(2), 145-149. doi: 10.21608/ejsur.2003.374676
Ibrahim H. Othman; Abdel-Moneim A. Nagy; Ayman A. El Nemr; Mohammad H. El Henedy; Sherief A. Mostafa; Fersan A. Sallam. "STENTED AUTOLOGUS VEIN GRAFT VERSUS GORE-TEX TUBE GRAFT FOR THE REPAIR OF COMMON BILE DUCT DEFECTS AN EXPERIMENTAL STUDY". test, 22, 2, 2003, 145-149. doi: 10.21608/ejsur.2003.374676
H. Othman, I., A. Nagy, A., A. El Nemr, A., H. El Henedy, M., A. Mostafa, S., A. Sallam, F. (2003). 'STENTED AUTOLOGUS VEIN GRAFT VERSUS GORE-TEX TUBE GRAFT FOR THE REPAIR OF COMMON BILE DUCT DEFECTS AN EXPERIMENTAL STUDY', test, 22(2), pp. 145-149. doi: 10.21608/ejsur.2003.374676
H. Othman, I., A. Nagy, A., A. El Nemr, A., H. El Henedy, M., A. Mostafa, S., A. Sallam, F. STENTED AUTOLOGUS VEIN GRAFT VERSUS GORE-TEX TUBE GRAFT FOR THE REPAIR OF COMMON BILE DUCT DEFECTS AN EXPERIMENTAL STUDY. test, 2003; 22(2): 145-149. doi: 10.21608/ejsur.2003.374676

STENTED AUTOLOGUS VEIN GRAFT VERSUS GORE-TEX TUBE GRAFT FOR THE REPAIR OF COMMON BILE DUCT DEFECTS AN EXPERIMENTAL STUDY

The Egyptian Journal of Surgery
Volume 22, Issue 2, April 2003, Pages 145-149    PDF (571.61 K)
Document Type: Original Article
DOI: 10.21608/ejsur.2003.374676
Authors
Ibrahim H. Othman* 1; Abdel-Moneim A. Nagy1; Ayman A. El Nemr1; Mohammad H. El Henedy1; Sherief A. Mostafa1; Fersan A. Sallam2
1Department of General Surgery, Faculty of Medicine, Tanta University, Egypt
2Department of Pathology,Faculty of Medicine, Tanta University, Egypt
Abstract
This experimental study compared the effectiveness of using a stented autologus vein graft versus Gore-Tex tube graft in 
the repair of large defects of the common bile duct (CBD) in a canine model. A 3-cm segment of the great saphenous vein and a 2-cm segment of the CBD were removed from ten healthy dogs with normal blood biochemistry levels (Group A). A stent was introduced into the proximal end of the CBD, through the vein segment and into the distal end of the CBD. The venous graft was then sutured to the CBD. A 2-cm segment of the CBD was removed and was replaced with a 2-cm segment of Gore-Tex tube for another ten healthy dogs with normal blood biochemistry levels (Group B). A liver biopsy was taken for histopathological examination during laparotomy and relaparotomy 15 days after graft implantation. Blood samples were obtained for biochemical examinations on postoperative days 5,10 and 15. In Group A, 1 dog died after 5 days with complete disruption in the upper anastomosis and biliary leakage (10%). Complete healing of the anastomosis occurred in 9 dogs (90%). In Group B 3 dogs (30%) died with complete disruption in the upper anastomosis (2 dogs- 20%) and in both anastomoses (1 dog -10%) and biliary leakage. Partial disruption occurred in the upper anastomosis in 3 dogs (30%) and in the lower anastomosis in 2 dogs (20%) with biliary leakage. Complete healing was confirmed in 2 dogs (20%). In the 7 surviving dogs the Gore–Tex graft was surrounded by fibrosis and its lumen was obturated by clots in 2 dogs (20%). No changes in liver biopsies or blood biochemistry were observed in surviving dogs of either group. 
We conclude that the use of an autologus vein graft and stent to repair CBD injuries could be a feasible method of treatment and that its use is more effective, safe, economic and practical than Gore-Tex tube graft although it is more difficult and time consuming. We found that the Gore-Tex tube graft is not a god alternative to repair CBD injuries but longer follow up may yield a better outcome.
Keywords
Repair of common bile duct defects; Stented autologus vein graft; Gore; Tex graft
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