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PubMed2005

New method for treatment of high hepaticocholedoch strictures (experimental research).

The purpose of the investigation was to achieve hepaticocholedoch recovery with preserved sphincter apparatus. The experiments were carried out on 25 mongrel dogs of both sexes with body weight 12-25 kg. The animals were divided into 3 groups. The hepatocholedoch strictures were induced in the animals of group I (n=10) and II (n=10). On the 4th day following modeling the animals of group II were subjected to relaparatomy, stricture removal and hepatocholedoch distraction by means of distraction device developed by prof. Kakabadze (patent request submitted for approval). On the 18th day after the surgical procedure the animals have undergone the surgery, the distraction device was removed and the anatomical integrity of biliary tract was restored by bilio-biliary anastomosis. Performed investigations have shown that all of the animals of group I have died on the several time points after the surgery. The cause of death was cholestasis. As to animals of group II, 2 dogs have died on 24 and 35 days after the surgery because of technical shortages of the bilio-biliary anastomosis. The rest 8 experimental animals undergo surgery and postoperative period normally and they were under observation in vivarium standard conditions correspondingly. The i.v. cholangiography, performed in survived animals during postoperative period, showed compete contrast liquid flow into the duodenum. The histological test performed during distraction showed mucosal layer sclerosis. Distraction and afford made evident influence on the muscular fibers through the duct axis. Their elongation and attenuation was mentioned after 3 days from distraction. The fibroblasts local accumulation was seen. The hepaticocholedoch mucosal complete recovery was seen after apparatus was taken out and the bilio-biliary anastomosis was done. Thus, new method of hepaticocholedoch strictures surgical correction elaborated by us allows us to restore anatomical integrity of biliary tract with preserved Oddi sphincter.

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