Single-Stitch Telescopic Bilioenterostomy in an Animal Model

ABSTRACT

Background/Aims: An end-to-side biliodigestive anastomosis is the most common procedure performed in hepato-pancreato-biliary surgery, and this procedure may become technically demanding. A telescopic ureterovesical anastomosis is frequently used in transplant surgery. The aim of this study was to investigate the feasibility of constructing a telescopic biliodigestive anastomosis. Methodology: The technique-standardization (n = 8) and main study (n = 3) groups were formed from 11 pigs. A single-stitch telescopic anastomosis with a self-disposable internal stent was performed in the main study group. The animals were sacrificed at the end of the 4-week follow-up period, and cholangiograms and tissue samples were obtained. Repeated biological, hematological, and biochemical data were recorded. Results: No bilomas or functional biliary strictures were identified in any of the main study group animals. Light microscopy revealed intestinal metaplasia of the biliary epithelium in the portion of the bile duct telescoped inside the intestinal lumen. Conclusions: Telescopic bilioenterostomy with a single pull-through stitch and a self-disposable stent is quick and reproducible in animal models, and it appears to be free of complications. Further experiments with longer follow-up periods are required to confirm that this anastomotic technique does not lead to episodes of delayed cholangitis or development of adenocarcinoma.

Keywords: :

• liver
• biliary tree
• hepaticojejunostomy
• hepaticoduodenostomy
• biliodigestive anastomosis
• technique