Utilization of Jejunal Segment has Benefit for Reconstruction of the Extrahepatic Bile Duct in the Canine

The feasibility of utilization of the jejunal segment or appendix as the substitute for reconstruction of the common bile duct in biliary surgery was investigated in the canine. Four dogs were used the appendix for biliary reconstruction, and 3 died within 3 months because of cholangitis associated with a stenosis of the anastomotic portion. Nevertheless, 9 dogs, which were replaced by the jejunal segment, survived with no serious complications. Values of serum chemistries were within the normal range during the observation period of 12 months after surgery. No bile leakage, anastomotic stenosis or dilatation of the common bile duct were observed on fistulography from the T-tube examined after surgery. Postmortem histological examination of the graft tissue showed presence of clear distinction between the mucosa of the bile duct and the small intestine. In addition, the epithelium of the small intestine was atrophic and resemble to the adjacent biliary epithelium. Thus, replacement of the intestinal segment reformed by absorbable autosuture appears to be clinically useful for reconstructive bibiary surgery which can preserve the function of the papilla in selected patients