A gallbladder flap for reconstruction of the common bile duct. An experimental study on pigs.

Background/purpose: In this article we investigate whether a gallbladder flap could be used for reconstruction of the common bile duct (CBD), thereby providing drainage via an intact sphincter of Oddi.

Methods: Eight LWD pigs were used for the experiments. The gallbladder was dissected from its fossa, care being taken not to damage its vessels. The CBD was then displayed and approximately 5 mm resected. In two pigs a tube, and in six pigs a sphere, was constructed from the gallbladder flap. Anastomoses were constructed between the gallbladder flap and the CBD. Blood samples were drawn and on day 10 a laparotomy and an intraoperative cholangiography was performed.

Results: No pigs showed any sign of biliary leakage and standard liver parameters were not affected by surgery. In the two pigs who had a tube constructed, cholangiography showed extrahepatic stenosis and intrahepatic biliary dilatation. In the six pigs who had a sphere constructed, cholangiography was without any sign of extrahepatic stenosis or intrahepatic dilatation.

Conclusion: Reconstruction of the CBD by way of a gallbladder flap seems to be a safe procedure to accomplish biliary drainage. This procedure could be of clinical significance for reconstruction of the CBD after resections for benign strictures and tumors, and for reconstruction after blunt or penetrating trauma. In this article we investigate whether a gallbladder flap could be used for reconstruction of the common bile duct (CBD), thereby providing drainage via an intact sphincter of Oddi.