[Early prognosis of free venous autograft in common bile duct reconstruction. Experimental study--first phase]

Experiments were carried out on 25 grown-up dogs of both sex in general anesthesia. The supraduodenal part of the choledochus was excised and the reconstruction of the defect with a free venous autograft was made by an end to end anastomosis without use of a transitory or permanent prosthesis. The experimental animals were observed for 60 days, during which period they were checked clinically, biochemically and radiologically. After this period the animals were sacrificed and surgical peroperative control and sampling of material for histological study were made. Out of 25 experimental animals 18 (72%) survived a period of 60 days and 7 dogs died. On autopsy it was found that the cause of death in all animals was biliary peritonitis, but in only one case due necrosis of the graft. The values of bilirubin concentration at the end of the experiment showed almost normal level, but the values of the alkaline phosphate activity and transminase showed significant increased values. Intravenous biligraphy showed significant excretion of the contrast material, freely passing the graft, which was dilated due to stenotic changes of the distal anastomosis. After sacrificing the animals we found: the graft increased length, diameter, thickness wall and stenosis of the distal anastomosis. By histological exploration we found in the liver the signs of the biliary stasis and in the grafts substitution of its endothelium by biliary epithelium. Free venous autograft used as a substitute in the reconstruction of the bile duct which survived 60 days postoperatively, remained transient but with changes in the sense of elongation and dilatation caused by the stenosis od distal anastomosis. Histologically the grafts were entirely bridged by biliary epithelium.