External metallic circle in microsurgical anastomosis of common bile duct

Background: Biliary stricture development is one of the most serious proble ms following biliary tract surgery. Here, we present a new technique for bi liary tract reconstruction with an external metallic circle, and the result s of this new technique in a rat model. Methods: Twelve male Sprague-Dawley rats (250 to 300 a were divided into tw o groups. After transection of the bile duct, standard bile duct reconstruc tion (without the metallic circle) was performed in group 1 and reconstruct ion with the external metallic (silver) circle was performed in group 2. At the end of the fourth month, clinical, laboratory biochemical, and histopa thologic parameters were compared between the groups. Results: Serum concentrations of alkaline phosphatase (ALP) and operation t ime were higher in group I than in group 2. Differences were statistically significant. In histopathologic examination, biliary duct stricture was see n in group 1. Foreign body reaction and fibrosis in the bile duct wall were seen in group 2. Conclusion: An external metallic circle prevents development of biliary str icture after primary end-to-end bile duct anastomosis in this rat model. (C ) 2001 Excerpta Medica, Inc. All rights reserved.