An experimental study on the effect of minimal bile leakage on biliary anastomotic stricture

Objective To explore the effect of minimal bile leakage on pathologic procedure of biliary anastomotic stricture.Methods 24 experimental Bama mini-pigs were randomly divided into three groups.The sham operation group(group S),we stabbed(not actually anastomosed)the bile duct two circles by anastomotic needle after dissecting the bile duct.The control group(group C),we excised the bile duct 5mm in length after dissecting the bile duct and treated by end-to-end anastomosis.The treatment group(group T),we treated in the same way as the group C and drained the bile by insefling a Forley arethral catheter(NO.8)in the bile duct above the anastomotic stoma 15 mm,then infused water into the air chamber(the amount was determined by the diameter of the bile duct)to block the bile flow passing the anastomotic stoma.Then we analyzed the degree of hyperplasia in each group and the ratio of the diameter of the anastomotic stoma to the bile duct above.Results There were anastomotic stoma hyperplasia and decrease in diameter in group S and group C.the lenghth of the wall of the bile duct was(1.5±0.2)mmand(1.6±0.3)mm.but when compared each other the result was not statistically significant(P＞0.05).Hyperplasia also existed in group T,the lenghth of the wall of the bile duct was(0.9±0.2)mm,when compared with S and C the results were statistically significant(P＜0.05).The SB of the drainage of group T,group,S and group C was(36.8±5.4),(141.9±17.7),(107.5±11.6)μmol/L,when compared with S and C the results were statistically significant(P＜0.01).Conclusion The minimal bile leakage of the anastomotic stoma plays an important role in biliary anastomotic stoma stricture.If measures can be taken to prevent the chronic stimulation of minimal bile leakage,the stricture formation will be inhibited obviously. Key words: Minimal bile leakage; Biliary anastomotic stoma; Stricture