Biliary tract reconstruction using an autologous vein graft in rats

Numerous biologic and synthetic materials have been used with limited succe ss as an interposed graft to repair segmental common bile duct (CBD) defect s. The authors report here that an autologous vein graft can be successfull y used to correct a CBD deficit, contingent on accurate microsurgical techn ique, immediate stenting, and rapid graft vascularization. Thirty Sprague-D awley rats underwent laparotomy, and the experimental group (n=25) had a 3- mm segment of the CBD excised. The CBD defect was repaired using an interpo sed femoral vein graft aided by a plastic stent. The control group (n=5) ha d the CBD cut and repaired by means of primary anastomosis. The experimenta l group was subdivided into three sub-groups, each examined at three differ ent postoperative intervals: 1, 4, and 12 weeks. The results showed that in flammation was apparent in the venous wail following the first postoperativ e week. A progressive loss of the vascular endothelium and replacement with the columnar epithelium typical of the CBD was seen in the vein graft. Nin eteen of the 25 experimental rats (76 percent) of the animals survived with out complication from the surgery, and there were no abnormalities in the l iver biochemical tests of these animals. Any biliary tract obstruction that developed was attributed to dislocation of the stent leading to collapse o f the vein graft (experimental group), or constriction of the anastomosis ( control group). This study demonstrates that biliary tract reconstruction u sing an autologous vein graft can be successfully performed in a rat model of CBD repair. The application of this method to the clinical setting is al so discussed.