Comparison of barbed suture and nonbarbed suture for laparoscopic cholecystoduodenostomy in rabbits: a randomized controlled trial.

This study aims to compare the applied efficacy of barbed suture versus non-barbed suture, as well as various stitching techniques, for laparoscopic cholecystoduodenostomy (LCD) in rabbits (imitating infants) to determine the most viable suture option. LCD was performed in a total of 45 male New Zealand white rabbits. The rabbits were equally divided into three groups: the SFB group (single-layer full-thickness running suture using barbed sutures), the SSB group (simple seromuscular layer running suture using barbed sutures) and the PDS group (single-layer full-thickness running suture using PDS sutures). The incidence of anastomotic complications, and histopathological outcomes were evaluated and compared across the groups. The mean duration for LCD was 9.6 ± 1.2 min in the SFB group and 10.8 ± 1.5 min in SSB group, both significantly shorter than the 12.0 ± 0.9 min observed in the PDS group (P < 0.001). Three cases of bile leakage were found in SFB group. H&E staining clearly revealed two cases of ectopic mucosal tissues at the anastomotic muscular layer in the SFB group. The collagen fibers, transforming growth factor-beta1 (TGF-β1), α-smooth muscle actin (α-SMA) and interleukin 6 (IL-6) of anastomotic tissues at all examined time points post-surgery were generally higher in SFB group than in the other two groups, with some statistically significant differences. No significant differences were observed between the SSB group and PDS group. The findings demonstrate that for barbed sutures, full-thickness technique was inferior to PDS sutures due to a higher bile leakage rate, whereas the seromuscular technique achieved difficult to hepatic duct. As a result, barbed sutures are not recommended for use in infants.