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Healing of Stoma After Magnetic Biliary-Enteric Anastomosis in Canine Peritonitis Models
Authors:Jian-hui Li  Long Guo  Wei-jie Yao  Zhi-yong Zhang  Shan-pei Wang  Shi-qi Liu  Zhi-min Geng  Xiao-ping Song  Yi Lv
Institution:Jian-hui Li(Department of Surgical 0ncology, Shaanxi Provincial People’s Hospital The Third Affiliated Hospital of the School of Medicine Xi’an Jiaotong University, Xi’an 710068, China);Long Guo(Research Institute of Advanced Surgical Technology and Engineering, Xi’an Jiaotong University, Xi’an 710061, China);Wei-jie Yao(Department of Surgical 0ncology, Shaanxi Provincial People’s Hospital The Third Affiliated Hospital of the School of Medicine Xi’an Jiaotong University, Xi’an 710068, China);Zhi-yong Zhang(Department of Surgical 0ncology, Shaanxi Provincial People’s Hospital The Third Affiliated Hospital of the School of Medicine Xi’an Jiaotong University, Xi’an 710068, China);Shan-pei Wang(Research Institute of Advanced Surgical Technology and Engineering, Xi’an Jiaotong University, Xi’an 710061, China);Shi-qi Liu(Research Institute of Advanced Surgical Technology and Engineering, Xi’an Jiaotong University, Xi’an 710061, China);Zhi-min Geng(Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China);Xiao-ping Song(Research Institute of Advanced Surgical Technology and Engineering, Xi’an Jiaotong University, Xi’an 710061, China);Yi Lv(Research Institute of Advanced Surgical Technology and Engineering, Xi’an Jiaotong University, Xi’an 710061, China);
Abstract:Objective To assese the healing of stoma after magnetic anastomosis for the reconstruction of biliary-enteric continuity under severe inflammation. Methods Acute bile duct injury was constructed as a bile peritonitis model in mongrel dogs (n=32). Magnetic anastomosis (group A, n=16) and traditional suture anastomosis (group B, n=16) were performed to reconstruct the biliary-enteric continuity in one stage. Half of the dogs in each group were euthanized on the 30th postoperative day, and the other half on the 90th postoperative day to harvest the stoma region. The healing conditions of the stoma after the 2 anastomotic approaches were observed with naked eyes, under light microscope and scanning electron microscope. Results The stoma leakage rate (50%versus 0%on the 30th postoperative day, 37.5%versus 12.5%on the 90th postoperative day, both P<0.05) and stenosis degree (13.9%±0.3%versus 7.1%±0.3%on the 30th postoperative day, 17.2%±0.4%versus 9.4%±0.4%on the 90th postoperative day, both P<0.01) were significantly higher in group B than in group A. Compared with traditional manual anastomoses, the histological analysis under light and electron microscope showed a more continuous stoma with more regular epithelium proliferation and collagen arrangement, less inflammation in group A. Conclusions Magnetic anastomosis stent ensures better healing of the stoma even under the circumstance of severe inflammation.
Keywords:magnetic anastomosis  biliary-enteric anastomosis  bile duct injury  cholangiojejunostomy  histological study  stoma healing
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