Gallengangsplastik mit gestieltem Jejunum-Transplantat

Summary

A pedunculate patch, obtained from a disconnected segment of jejunum, was implanted into the longitudinal incision of the ductus choledochus.

Intra-operatively, the findings were based upon direct cholecystocholangiography; postoperatively, upon laboratory tests. After an observation period of 12 months a new cholangiography of the transplant was made along with a selective picture of the mesenteric arteries. The choledochus duct with the transplant was examined histologically.

Three dogs died immediately postoperatively of peritonitis due to suture insufficiency. Five dogs died of invaginate ileus. These animals, as well as the remaining 8 dogs showed macroscopically and microscopically a smooth and uneventful healing of the transplant at the end of the observation period. Radiographies showed free flow of the biliary duct system.

The selective mesenteric arteriographies evidenced beginning anastomosis between the transplant and the capillaries of the bile duct.

Based on the results presented, the pedunculate jejunal graft can be considered well suited as an expansion graft for the bile duct.

Zusammenfassung

Bei 16 Hunden wurde aus einem ausgeschalteten Jejunumsegment ein gestielter Patch gewonnen und in den längsincidierten Ductus choledochus eingenäht. Der Befund wurde intraoperativ röntgenologisch dokumentiert, der weitere Verlauf durch Laborbestimmung kontrolliert. Nach einer Nachbeobachtungszeit von bis zu 12 Monaten wurden eine erneute Cholangiographie sowie eine selektive Mesenterialarteriendarstellung des Transplantates durchgeführt, der Ductus choledochus mit Transplantat wurde histologisch untersucht.