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Effects of bile on arterial anastomosis in a rat model

Kamil Kilic, Gokhan Temiz, Murat Zeytunlu, Murat Kilic, Mehmet Alper.

Abstract
Objective: Liver transplantation has been one of the areas in which microvascular surgery is frequently practiced. With the use of microsurgical techniques in hepatic artery anastomosis, the incidence of hepatic artery thrombosis has been signifi- cantly reduced. Hepatic artery anastomosis is realized after the anastomoses of the hepatic vessel and portal vessel are completed, and clamps are removed; in other words, after hepatic circulation starts. During hepatic artery anastomosis, bile runs towards the hepatic artery anastomosis line. This study aimed to investigate effects of bile on arterial anastomosis.
Materials and Methods: Forty male Sprague Dawley rats were randomly divided into 2 groups. Femoral artery anasto- mosis was performed in rats of the control group (n = 20) through heparinized serum (10 U/ml) irrigation. In the rats of the study group (n = 20), however, femoral artery anastomosis was performed through heparinized serum (10 U/ml)+0.5 cc bile irrigation. After the 1st week, anastomosis patency was evaluated with color duplex ultrasonography. A 1 cm segment of the femoral artery involving the anastomosis line was removed for histopathological evaluation.
Results: In the control group, no flow to the distal was observed in one anastomosis. All the anastomoses in the study group were patent. Histopathologically, perivascular polymorphonuclear leucocyte infiltration was observed in the study group. No statistically significant differences were observed for endothelial continuity and intimal thickening, and no statisti- cally significant differences were observed for anastomosis patency.
Conclusions: In the light of these findings, it was determined that bile contamination did not have any negative or positive effects on artery anastomosis.

Key words: Bile, hepatic artery anastomosis, microsurgery



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