This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (46)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Harry B. Kram, MD; Miguel A. Garces, MD; Stanley R. Klein, MD; William C. Shoemaker, MD

Arch Surg. 1985;120(11):1250-1256.

Abstract
• Transection of the common bile duct (CBD) secondary to iatrogenic or civilian trauma is a devastating injury associated with a high incidence of complications, especially biliary fistula and stricture formation. We evaluated the efficacy of Fibrin Sealant—a biologic adhesive containing highly concentrated human fibrinogen—in primary end-to-end anastomosis of the transected CBD in ten adult mongrel dogs. Postoperative T-tube stents in the CBD anastomosis and abdominal drainage were not used. Only two absorbable sutures were used for each CBD anastomosis. The dogs were reexplored postoperatively at intervals varying from one week to nine months; cholangiography was performed at postoperative intervals varying from one to six months. Examination of CBD specimens harvested one month or more after surgery revealed complete healing and no signs of previous injury. Histologic examination disclosed well-healed ductal tissue, without a significant inflammatory response. One dog had an anastomotic leak, and two had moderate narrowing of the CBD anastomosis. Our experience in experimental CBD anastomosis indicates that Fibrin Sealant (1) helps seal biliary anastomoses against leakage; (2) controls bleeding from cut edges of bile duct segments; (3) has good systemic and local compatibility; (4) may promote bile duct wound healing; and (5) significantly reduces the number of sutures needed for primary repair, thereby decreasing the potential for anastomotic ischemia, mucosal damage, and biliary stricture formation.

(Arch Surg 1985;120:1250-1256)

Author Affiliations
From the Departments of Surgery (Drs Kram, Klein, and Shoemaker) and Pathology (Dr Garces), Harbor-UCLA Medical Center, Torrance, Calif, and the UCLA School of Medicine.

Footnotes
Accepted for publication Aug 5, 1985.

Read before the Annual Meeting of the Southern California Chapter of the American College of Surgeons, Coronado, Calif, Jan 19, 1985.

Reprint requests to the Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA 90509 (Dr Shoemaker).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Biliary-Enteric Anastomosis by Means of a Single Layer of Serosubmucosal Sutures Without T-Tube Drainage
Kuroda et al.
Arch Surg 1996;131:637-639.
ABSTRACT  

Fibrin Glue Sealing for the Prevention of Pancreatic Fistulas Following Distal Pancreatectomy
Suzuki et al.
Arch Surg 1995;130:952-955.
ABSTRACT  

Fibrin Sealant Adhesive Systems: A Review of Their Chemistry, Material Properties and Clinical Applications
Sierra
J Biomater Appl 1993;7:309-352.
ABSTRACT  

Effect of Aerosolized Fibrin Solution on Intraperitoneal Contamination
Dubrow et al.
Arch Surg 1991;126:80-83.
ABSTRACT  

Effects of fibrin sealant on incorporation of autograft and xenograft tendons within bone tunnels: A preliminary study
Shoemaker et al.
Am J Sports Med 1989;17:318-324.
ABSTRACT  

Common Bile Duct Healing: Do Different Absorbable Sutures Affect Stricture Formation and Tensile Strength?
Sharp et al.
Arch Surg 1989;124:408-414.
ABSTRACT  

Fibrin Glue Achieves Hemostasis in Patients With Coagulation Disorders
Kram et al.
Arch Surg 1989;124:385-387.
ABSTRACT