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Do Different Absorbable Sutures Affect Stricture Formation and Tensile Strength?

Kenneth W. Sharp, MD; Charles B. Ross, MD; Vicki N. Tillman; John F. Dunn, MD

Arch Surg. 1989;124(4):408-414.

Abstract
• Few basic investigations have addressed the problem of common bile duct strictures. We systematically investigated the healing canine end-to-end choledochal anastomosis and tested the hypothesis that common bile duct anastomoses sutured with monofilament polyglyconate absorbable suture would heal with less stricture formation and greater tensile strength than those sutured with braided polyglactin 910 and chromic catgut sutures. Seventy-six canines, randomized to control vs sutured groups, underwent either mobilization (controls) or transection of the mid—common bile duct and were allowed to heal 5, 10, 15, or 50 days postoperatively before sacrifice. The type of absorbable suture used to construct a common bile duct anastomosis was found to have no major effect on anastomotic strictures nor on anastomotic breaking strength. Polyglyconate suture caused significantly less perianastomotic inflammation than did chromic suture, with polyglactin 910 sutures evoking an intermediate inflammatory response. Surgeons may safely choose sutures for biliary procedures based on the clinical circumstances and personal preference.

(Arch Surg. 1989;124:408-414)

Author Affiliations
From the Departments of Surgery, Nashville Veterans Administration Medical Center (Drs Sharp, Ross, and Dunn), and Vanderbilt University Medical Center (Drs Sharp, Ross, and Dunn and Ms Tillman), Nashville, Tenn.

Footnotes
Accepted for publication December 16, 1988.

Presented as a poster exhibit at the 12th Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Minneapolis, Minn, May 13-14, 1988.

Reprint requests to Department of Surgery, Nashville Veterans Administration Medical Center, 1310 24th Ave S, Nashville, TN 37212 (Dr Sharp).

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