The effect on survival of thoracic duct ligation in experimental peritonitis.

BACKGROUND/AIMS: It has been shown that systemic bacteremia and endotoxemia in peritonitis is mainly related to lymphatic transport via the thoracic duct. This study was performed to investigate the effect on mortality of thoracic duct ligation in experimental peritonitis. METHODOLOGY: Thirty dogs were divided into three groups. Groups I, II, and III were control, unligated, and ligated thoracic duct peritonitis groups, respectively. Liver biopsy, blood and peritoneal fluid cultures were taken and survival time was established. RESULTS: Bacteria were determined in peritoneal fluid in all animals in groups II and III. Growing bacteria numbers in group III were two times higher than in group II. While bacterium was grown on blood cultures in all group II animals, growing was determined on blood cultures in only 2 animals in group III. Diffuse necrosis was determined in the liver of 2 animals who died within 72 hours in group II. Another 8 animals had minimal focal necrosis in their livers. Diffuse and progressive necrosis was determined in the liver of all animals in group III. The difference between liver necrosis in group II and group III was found to be statistically significant (p = 0.002). CONCLUSIONS: This experimental study demonstrates that thoracic duct ligation decreases bacteremia rates clearly but that mortality increases significantly.

Use of an autologous vein graft and stent in the repair of common bile defects: an experimental study.

We investigated the effectiveness of using an autologous vein graft and stent in the repair of large defects of the common bile duct (CBD) in a canine model. A 3-cm segment of the vena cephalica antibrachii and a 2-cm segment of the CBD were removed from eight healthy mongrel dogs with normal blood biochemistry levels. A stent was passed through the vein segment, and one end was introduced into the proximal end of the CBD while the other end was introduced into the distal end. The venous graft was then sutured to the CBD. A liver biopsy was taken for histopathological examination during laparotomy and relaparotomy. Blood samples were obtained on postoperative days 7, 14, and 20 for biochemical examination. The defect was effectively repaired by the autologous vein graft and stent in 7 dogs, after the exclusion of 1 dog that died of hemorrhage 3 days after the operation. No change in blood biochemistry was observed postoperatively, and no histopathological change in the liver was found in the preoperative or postoperative periods. These findings indicate that the use of an autologous vein graft and stent to repair CBD injuries may be a feasible and alternative method of treatment.

Protection of intestinal anastomoses in septic environment with peritoneal graft and polyglycolic acid mesh: an experimental study.

We carried out an experimental study in dogs to evaluate the outcome of large bowel anastomosis with 6 stitches (Group C, n : 6) in a septic environment with protection by a polyglycolic acid (PGA) mesh (Group M, n : 12) or peritoneal graft (Group P, n : 12). Thirty dogs were used to compare the techniques. Two dogs in each group were re-operated after 3, 5, 7, 14, 28 and 90 days. They were evaluated for adhesion formation, lumen diameter (anastomotic index), clinical features, histologic appearance and quality of healing at the anastomotic sites. All dogs in group P and group M survived, whereas 2 dogs in the control group died of anastomotic leakage and 3 dogs were re-operated for anastomotic leakage and peritonitis. In group M, one dog was reoperated because of the anastomotic leakage and two dogs were reoperated because of the anastomotic stenosis. Also, 4 anastomoses showed evidence of moderate stenosis. In group P, three anastomoses were graded as minimal stenosis. Histopathologic evaluation showed more complete epithelization, less inflammation, and less adhesion in group P than group M. We could not find any study in the literature that described and compared both techniques. We report here the results of such a study.