Feasibility of bile duct as venous graft for venous reconstruction in pancreatic surgery: An animal experimental study

Vascular. 2020 Aug;28(4):450-456. doi: 10.1177/1708538120902653. Epub 2020 Mar 2.

Abstract

Objective: Pancreatic cancer is a kind of high malignant tumor with a poor prognosis. The aim is to determine whether the dilated bile duct can be used to reconstruct the vessels.

Methods: An animal model of jugular vein and portal vein reconstruction was established using the bile duct. A total of 20 landrace pigs were selected to undergo jugular vein reconstruction or portal vein reconstruction using the bile duct as a patch or bridge. The patency was evaluated by color Doppler, the reconstructed segments were removed and examined macroscopically and histologically at specified intervals, and the results were compared with synthetic vessels (IMPRA straight, 10s03-19).

Results: The lumen was patent, although a low level thrombosis was observed when jugular or portal vein patching was used. For bridging, stenosis of the lumen was observed, and necrosis appeared when the bile duct was used for bridging, indicating that it is feasible to reconstruct the jugular vein and portal vein with a bile duct patch. However, the bridge was not feasible possibly due to loss of blood supply, and consequent necrosis and fibrosis.

Conclusion: The bile duct is technically feasible, but the outcomes are unsatisfactory.

Keywords: Pancreaticoduodenectomy; bile duct; jugular vein; portal vein; venous reconstruction.

MeSH terms

  • Animals
  • Bioprosthesis*
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Common Bile Duct / pathology
  • Common Bile Duct / physiopathology
  • Common Bile Duct / transplantation*
  • Feasibility Studies
  • Female
  • Fibrosis
  • Graft Survival
  • Jugular Veins / pathology
  • Jugular Veins / physiopathology
  • Jugular Veins / surgery*
  • Male
  • Models, Animal
  • Necrosis
  • Pancreas / surgery*
  • Portal Vein / pathology
  • Portal Vein / physiopathology
  • Portal Vein / surgery*
  • Sus scrofa
  • Time Factors
  • Vascular Patency