Bile Duct Replacement Using Bovine Pericardial Patch Graft: an Experimental Study

PURPOSE: The repair of common bile duct injuries is a complex procedure that has a significant rate of postoperative morbidity and mortality. The aim of this study was to demonstrate the usefulness of the bovine pericardial patch (BPP) graft for replacement of the bile duct. METHODS: In this study, BPP with Indermil glue was used to evaluate the effectiveness, morphological changes, early complications and changes of BPP's character. Four male pigs weighing 30~40 kg each were used in the study. We attached a BPP on the small size defected common bile duct (CBD) surface of one pig with using Indermil glue. Another pig's segment of the CBD was resected and the biliary tract was replaced by a tube formed from BPP. After 2 weeks, these animals were sacrificed and we analyzed the patch attachment, the cholangiography and morphological changes. RESULTS: We made a tube-like form from BPP with Indermil; we put it into saline (NaCl 0.9%), gastric juices and bile for 2 weeks to test the changes of the material and the strength of the attachment. Nothing changed, and the attachment remained secure. After 2 weeks these animal were sacrificed and the patch attachment was evaluated by cholangiography and the morphological changes. One significant adhesion with fibrosis in surrounding tissue was noted with obstruction of the CBD. CONCLUSION: These observations suggest that BPP with Indermil glue may well be an acceptable membrane in CBD replacement.

The Repair of Alimentary Tract Wall with Bovine Pericardium Patches and Glue? A Pilot Study

OBJECTIVE: To test the efficacy and possibility of bovine pericardial patch (BPP) for the repair of full-thickness defects in alimentary tract wall with Indermil(R) glue. BACKGROUND: There is a recent report of the successful replacement of duodenal wall with patches of ePTFE. This finding requires confirmation, Repair of other segments of the abdominal intestinal tract also merit further study. The repair of perforations of the gastrointestinal tract remain challenging. METHODS: In this study, BPP with Indermil(R) glue was used to evaluate the effectiveness, strength, adhesion formation, morphological changes, early complications and change of BPP character. We attached a BPP on the peritoneal surface of three pigs with Indermil(R) glue. After 3 weeks these animals were sacrificed and we analyzed the patch attachment. RESULTS: We made a tubelike form with BPP and Indermil(R); put it in saline (NaCl 0.9%), gastric juices and bile for 2 weeks to test the changes in the material and the strength of the attachment. Nothing changed, The attachment remained secure. We tested the BPP with glue attached to the alimentery tract and liver surface. There were no patch failures. For the next study we attached a BPP on the peritoneal surface. After 3 weeks these animal were sacrificed and the patch attachment was evaluated. One significant adhesion with fibrosis in surround tissue was noted. In this animal more Indermil(R) glue was used. Serosal surface healings was complete in all animals at 3 weeks. CONCLUSION: These observations suggest that BPP with Indermil(R) glue may well be an acceptable membrane for at least temporary replacement of the peritoneral surface. Further study is required.