Schanaider Alberto, Pannain Vera Lucia Nunes, Müller Lucas Cristo Conilho Macedo, Maya Maria Cristina Araújo
Center of Experimental Surgery, Postgraduate Program in Surgical Sciences, Department of Surgery, Faculty of Medicine, UFRJ, Rio de Janeiro, Brazil.
Acta Cir Bras. 2011 Aug;26(4):247-52. doi: 10.1590/s0102-86502011000400001.
Analyze the morphological and structural outcomes of a patch of expanded polytetrafluoroethylene in the treatment of an iatrogenic injury of the common bile duct.
In Group 1 (Sham), 7 dogs underwent 3 laparotomies with intervals of 30 days between them. In Group 2, 10 dogs underwent transient common bile duct obstruction. After 30 days, this biliary occlusion was undone and a patch of expanded polytetrafluoroethylene replaced a fragment removed from the duct's wall. Thirty days after this last surgery, cholangiographic assessment of prosthesis patency and macro and microscopic evaluation of the biliary tract were performed. Daily clinical inspection completed the study outcomes. The Wilcoxon non-parametric test was used for statistical analysis.
In all dogs enlargement of the biliary tree diameter was observed 30 and 60 days after the first surgical procedure. Partial adhesion of the patch to the common bile duct as a free luminal foreign body was found in 6 dogs. The prosthesis was completely integrated to surrounding tissue in the remaining four.
Although a feasible option for the treatment of biliary duct iatrogenic lesions, the expanded polytetrafluoroethylene prosthesis must be used with caution considering the potential risks for complications.
分析一片膨体聚四氟乙烯在治疗胆总管医源性损伤中的形态学和结构结果。
第1组（假手术组），7只狗接受3次剖腹手术，每次间隔30天。第2组，10只狗接受短暂性胆总管梗阻。30天后，解除胆管阻塞，用一片膨体聚四氟乙烯替换从胆管壁取下的一段组织。最后一次手术后30天，进行胆管造影评估假体通畅情况以及对胆道进行大体和显微镜评估。每日临床检查完善研究结果。采用Wilcoxon非参数检验进行统计分析。
在所有狗中，首次手术后30天和60天观察到胆管树直径增大。6只狗中发现补片作为游离管腔内异物与胆总管部分粘连。其余4只狗中假体完全整合入周围组织。
尽管膨体聚四氟乙烯假体是治疗胆管医源性病变的一种可行选择，但考虑到并发症的潜在风险，必须谨慎使用。
