A Pilot Study of Common Bile Duct Reconstruction with CorMatrix Extracellular Matrix in Swine (Sus scrofa)
60 MDG CIF Travis AFB United States
Pagination or Media Count:
OBJECTIVES A new material made from pig intestine has been used to replace segments of blood vessels. We used this same material to replace common bile ducts CBD in pigs. METHODS A 1cm segment of CBD was removed from 10 anesthetized swine and replaced with a CorMatrixregistered trademark interposition graft. Cholangiograms were performed one week after surgery to assess graft patency and anastomotic leaks. Swine were euthanized on post operative day 45 and histopathology was performed. RESULTS One of ten pigs was used for technique development. Among the remaining nine pigs, three were euthanized after 24 to 48 hours due to bile peritonitis or bowel obstruction. Six pigs survived to the conclusion of the study. Two of these developed gastric ulcers. The remaining four pigs did well during the post-operative period. Tissues from six pigs were examined histologically. The bile duct grafts showed little evidence of cellular infiltration. Two grafts were infected. All six pigs showed evidence of mild to moderate extrahepatic cholestasis. CONCLUSIONS The injury model developed in this experiment was prone to causing early bowel obstructions and gastric ulcers. The CorMatrix interposition graft provided continuity for bile drainage, but led to strictures, leaks, cholestasis, and cholangitis.
- Medicine and Medical Research