An experimental evaluation of the types of material used for bile duct drainage tubes

A comparison has been carried out of the properties of latex, silicone, red rubber and polyvinyl chloride (PVC) T tubes draining the common bile duct in dogs. The tubes remained in the animals for 15-98 days. Bile cultures, liver function tests, cholangiograms and the histology of the common bile ducts were studied, and the changes in the physical properties of tubes implanted in the experimental animals, and of those after 1 month's incubation in human bile, were assessed. The elasticity of the tubes was also measured and the tissue reaction around them observed. Finally, the tissue reaction following implantation in mice of tubes which had been incubated in human bile for 1 month was investigated, and compared with that when new tubes were used. Polyvinyl chloride tubes caused the least reaction in both the common bile duct and the peritoneal cavity. However, the lack of tissue tract formation around them, owing to their inertness, and their rapid development of rigidity make them unsuitable for use in biliary surgery. Red rubber tubes were found to be the most irritant. While silicone tubes proved to have desirable physical properties compared with latex tubes, they did, however, disintegrate easily with improper handling on suturing and were slow to produce a satisfactory tract, the latter fact suggesting that they would be unsuitable for short term biliary drainage. It appears that the latex tube is the tube of choice for drainage periods of up to 3 months, while silicone tubes are preferable when intubation for longer periods is necessary. Red rubber tubes may be the alternative for routine short term drainage if a latex tube is not available.