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Common bile duct anastomosis using fibrin glue
Archives of Surgery (Chicago, Ill. : 1960)
|November 1, 1985
Summary
Fibrin sealant effectively aids in primary repair of transected common bile ducts (CBD) in dogs, promoting healing and reducing complications like biliary strictures. This biologic adhesive minimizes suture use, enhancing outcomes for CBD injuries.
Area of Science:
- Surgical Innovation
- Gastroenterology
- Biomaterials Science
Background:
- Common bile duct (CBD) transection from trauma leads to significant complications, including biliary fistula and strictures.
- Current management often involves complex reconstructive procedures and supportive measures like T-tube stents.
Purpose of the Study:
- To evaluate the efficacy of Fibrin Sealant in primary end-to-end anastomosis of transected CBDs.
- To assess Fibrin Sealant's role in preventing complications and promoting healing in CBD injuries.
Main Methods:
- Ten adult mongrel dogs underwent primary end-to-end anastomosis of transected CBDs using Fibrin Sealant.
- Minimal sutures (two absorbable) were used; T-tube stents and abdominal drainage were omitted.
- Dogs were reexplored and underwent cholangiography at various postoperative intervals.
Main Results:
- Complete healing of CBD specimens was observed by one month post-surgery, with no signs of previous injury.
- Histologic examination revealed well-healed ductal tissue with minimal inflammation.
- One instance of anastomotic leak and two cases of moderate CBD narrowing were noted.
Conclusions:
- Fibrin Sealant effectively seals biliary anastomoses, controls bleeding, and demonstrates good biocompatibility.
- It may promote bile duct wound healing and significantly reduces suture requirements, thereby lowering risks of ischemia and stricture formation.