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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2013, Number 3

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An Med Asoc Med Hosp ABC 2013; 58 (3)

Regeneration in complicated bile duct injury in adult dogs. Using the small intestine submucosa processed pork

Herrera MH, Melo MCN, del Pozzo MJA, Valanci AS

Language: Spanish
References: 57
Page: 155-162
PDF size: 276.17 Kb.


ABSTRACT

Introduction: With the advancement in the use of biomaterials in different tissue structures as a replacement or as a basis for the formation of these arises the concern of expanding the application of these to the management and repair of the injured bile duct. Objective: The aim was to demonstrate that the use of the SIS, as the graft is useful as a framework for the temporary replacement of the bile duct with acute, allowing complete regeneration in a canine model. Material and methods: In a canine model sample of 12 creoles dogs were operated, their bile duct was totally injured, the total circumference of the bile duct was replaced by a tube 360°. Surgisis (cook-biotech) was used to develop the SIS graft. They were divided into 3 groups by simple randomization which reoperated at 15 (clinical stage 1), 30 (clinical stage 2) and 60 days (clinical stage 3), sacrifice individuals to make histopathological study of the integration of material to the bile duct and formation of tissue in the different times required as well as support for X-ray cholangiography ante mortem, which assessed the presence or absence of leakage and full step or contrast medium into the bowel. The effectiveness of the replacement of the bile duct with SIS was assessed with macroscopic and microscopic histopathological parameters as well as cholangiography. Results: When performing laparotomy for placement of cholecystostomy tube for cholangiography, showed the presence of adhesions loose site of anastomosis to gallbladder individuals in group 1 and the presence of dense adhesions and loose cuts across individuals in the group 2 and 3. In all subjects, we observed the presence of discrete proximal dilatation of the bile duct. Cholangiography was observed during the appropriate step of the dye into the bile duct and duodenum. Acute inflammation was present in a low range in group 1, with a peak between 30 and 60 days, being absent at the end of 60 days. Chronic granulomatous inflammation had a tendency to increase in groups of 30 and 60 days. Conclusion: The SIS is a suitable material for grafting in the bile duct with acute injury, open or laparoscopic surgery. In the repair of a stenotic bile duct without requiring the use of a shunt biliodigestive. Potentially effective for development and placement endoscopically.


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