[One layer end to side choledochusduodenal anastomosis with evertion of the choledochus wall in swines]

Luiz Roberto do Nascimento, Murched Omar Taha, Djalma José Fagundes, Paulo de Oliveira Gomes, Neil Ferreira Novo
Acta Cirúrgica Brasileira 2005, 20 (1): 74-87

PURPOSE: This article aims to study the one layer end to side choledochusduodenal anastomosis creating a "neopapila" which, because of the mucosa recovering it, would prevent stenosis.

METHODS: Thirty male pigs were distributed within 3 equal groups = Group I (control)--conventional choledochusduodenal anastomosis. Group II (experiment)--one layer end to side anastomosis with evertion of the choledochus wall (neopapila). Group III (sham)--isolation and mobilization of the biliar tract with no choledocotomy. We got the biliar flow and pressure (pre and postoperative) monitorized on the 15 PO day the animals went trough an endoscopy and on the 30 PO day they were operated and the tissues were analysed under macro and microscopic view.

RESULTS: Regarding to biliar flow and manometry there were differences between all groups but the III. Animals in groups I and II showed intestinal metaplasia and diminished elastic fibers in the choledochus. All animals showed choledoco dilation.

CONCLUSION: The proposed technique allowed the same results as the standard technique.

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