PRIMARY CLOSURE OF CHOLEDOCHOTOMY USING CO2-LASER - COMPARISON WITH SUTURE CLOSURE

This study was designed to compare laser welding to suture closure of the common bile duct (CBD). A 12 mm linear choledochotomy was closed i n 12 mongrel dogs using tissue welding low-energy CO2 laser. Tissue we lding was accomplished at 5.0 w/cm2 for 120 sec. Twelve similar mongre l dogs (control) were treated with CBD closure using 5/0 Vicryl (polyg lactin 910, Ethicon, Inc., Somerville, NJ) interrupted simple stitches . All animals were sacrificed at six weeks. Gross and histologic evalu ation of the choledochotomy site were performed. There were no statist ical differences in parameters of comparison in the two groups. These parameters were pre- and post-treatment measurements of liver function tests, stenosis, and dehiscence. However, it must be noted that there was a 33% (4/12) incidence of dehiscence and death in the CO2 laser w elded choledochorrhaphy. This result, although not statistically signi ficant, is clinically significant. We conclude that the tensile streng th of CO2 laser welded CBDs must be optimized and that these results a re preliminary and still unreliable to recommend for clinical adaptabi lity. (C) 1993 Wiley-Liss, Inc.