[One layer end to side choledochusduodenal anastomosis with evertion of the choledochus wall in swines]. / Anastomose coledocoduodenal término-lateral em plano unico com eversão da parede do colédoco em suínos.

PURPOSE: This article aims to study the one layer end to side choledochusduodenal anastomosis creating a "neopapila" which, because of the mucosa recovering it, would prevent stenosis. METHODS: Thirty male pigs were distributed within 3 equal groups = Group I (control)--conventional choledochusduodenal anastomosis. Group II (experiment)--one layer end to side anastomosis with evertion of the choledochus wall (neopapila). Group III (sham)--isolation and mobilization of the biliar tract with no choledocotomy. We got the biliar flow and pressure (pre and postoperative) monitorized on the 15 PO day the animals went trough an endoscopy and on the 30 PO day they were operated and the tissues were analysed under macro and microscopic view. RESULTS: Regarding to biliar flow and manometry there were differences between all groups but the III. Animals in groups I and II showed intestinal metaplasia and diminished elastic fibers in the choledochus. All animals showed choledoco dilation. CONCLUSION: The proposed technique allowed the same results as the standard technique.

Anastomose coledocoduodenal término-lateral em plano único com eversão da parede do colédoco em suínos / One layer end to side choledochusduodenal anastomosis with evertion of the choledochus wall in swines

OBJETIVO: Estudar anastomose coledocoduodenal término-lateral em plano único, com a eversão da mucosa do colédoco e sua implantação em segmento do intestino, confeccionando-se uma "neopapila" que estando recoberta por mucosa afastaria a possibilidade de estenose. MÉTODOS: Foram estudados 30 porcos, machos, distribuídos em 3 grupos de 10 animais: Grupo I- controle-colédocoduodeno anastomose convencional. Grupo II- experimento-coledocoduodeno-anastomose com eversão da parede do colédoco (neopapila). Grupo III - simulado - isolamento e mobilização das vias biliares sem coledocotomia. Os parâmetros analisados foram o fluxo biliar e manometria pré e pós - operatória, endoscopia com 15 dias de PO, e com 30 dias os animais reoperados e avaliados do ponto de vista macro e microscópicos. RESULTADOS: A fluxometria e a manometria mostraram diferenças entre o pré e o pós-operatória nos grupos I e II, mas não no III. Nos animais dos grupos I e II,ocorreu metaplasia intestinal e diminuição das fibras elásticas do colédoco. Todos os animais apresentaram dilatação coledociana. CONCLUSAO: A técnica de realização de neopapila mostrou resultado semelhante à técnica convencional.

Percutaneous endoscopic gastrostomy in porcines performed with standard medical instruments used in a general hospital routine

PURPOSE: To perform a endoscopic gastrostomy by the introducer method with routine instruments used in a general hospital, without special instruments of special kits.METHODS: This procedure was performed in pigs (Sus scrofa domesticus) under observation for seven days and then submitted to euthanasia. The technique was evaluated for macroscopic and histologic parameters. RESULTS: All animals had a good evolution without major complications. Some minor complications ocurred like a rupture of Foley catheter balloon and subcutaneous space abscess.CONCLUSION: The percutaneous gastrostomy with routine general hospital instruments is sucessful performed, is safe, cheap and must be performed by skilled endoscopists.

Anastomose colédocoduonal término-lateral em plano único com eversäo da parede do colédoco em suínos / Single layer end to side cholodochoduodeno anastomosis with colecho wl eversion on swines

A reparaçao das lesoes traumáticas ou iatrôgenicas das vias biliares extra-hepáticas, em especial do colédoco, tem desafiado os cirurgioes há muito tempo. Várias técnicas operatórias têm sido propostas para contornar a principal complicaçao pré operatória que é a estenose. Uma dessas propostas (Mammana -1946) é a realizaçao eversao da mucosa do colédoco e sua implantaçao em segmento de intestino confeccionando-se uma "neopapila" que estando recoberta por mucosa afastaria possibilidade de estenose. Com esse propósito foi estudado experimentalmente 3 porcos, machos, distribuídos em 3 grupos: GI (n = 10): grupo controle colédocoduodeno anastomose convencional; GII (n = 10): grupo experimento colédocoduodeno anastomose com eversao da parede do colédoco (neopapila); GIII (n = 10): grupo simulado - isolamento e mobilizaçao das vias biliares. Os animais foram avaliados quanto ao fluxo biliar e manometria pré e pós-operatório; endoscopia aos 15 dias de PO; microscopia aos 30 dias de PO. A fluxometria e manometria mostraram resultados estatisticamente diferentes nos grupos GI e GII, quando se comparou estes parâmetros na operaçao e na reoperaçao. Entretanto estas mesmas comparaçoes nao obtiveram diferenças estatísticas no grupo GIII. Todos os animais apresentaram dilataçao do colédoco. Os animais dos GI e GII mostraram metaplasia intestinal e diminuiçao de fibras elásticas na parede do colédoco. Conclusao: a técnica de realizaçao de neopapila mostrou resultado semelhantes a técnica convencional

End-on extramucosal single layer suture with double anchoring in the submucosa on rabbits

The techniques of gastrointestinal surgical sutures have been frequently focused in controversial publications. These ones concern not only anastomosisÆ types but also about thread types and how to apply them. The values of the submucosa as layer of greatest resistence of the digestive tube was already known since the past century. The aim of this study is to avaluate the suture in an extramucosal single-layer suture with double anchoring of the submucosa, a technical detail not found in the searched literature. This experiment was carried out using 36 white,male adults New Zealand, rabbits divided into three groups which differed only regarding day of re-operation and euthanasia, as followed: group I ( 4 days), group II (7 days) and group III ( 15 days). Two transversal and parallel gastrotomies were perfomed in the same animal, one distal and other proximal, of with 4 cm extension each. In these gastrotomies two types of sutures were alternated : 1- End-on extramucosal single-layer suture and 2- End-on extramucosal single-layer suture, with double anchoring in the submucosa. Macroscopic and microscopic studies were perfomed on the suture line in both gastrotomies and in each period of euthanasia. Except for the serosa item whose results were similar for both sutures, statiscally, the extramucosal single-layer suture, with double anchoring of submucosa layer showed better macro and microscopic results than the extramucosal single-layer suture in group I (4 days). In the others periods of euthanasia (groups II and III), the statistical results were similar.

Study of blood count in the validity experimental appendicitis in rabbits

A group of thirty six rabbits was studied, with weight ranging from 2400 to 3100 grams, in order to evaluate the blood test on the validity of experimental acute appendicitis. In order to do that, the animals were distributed amony three groups of 12 rabbits each, that corresponded to observation periods of 24 hours(Group A), 48 hours(Group B) and 72 hours(Group C). The presence of macroscopic appendicitis was verified in all the rabbits of the experiment on the three studied periods. The blood test study showed statistic significance when reading the values of haemoglobin, haematocrit and monocytes in Group C; of total and segmented leucocytes, eosinophiles, limphocytes and monocytes in Group B; when the groups faced each other, however, there was no estatistic significance. So, it was concluded that the values of haemoglobin, red blood, white cells and haematocrit are not suitable markers for experimental appendicitis in rabbits.