Vascularized polyvinyl sponge prosthesis. Its use to replace the canine common bile duct.

Abstract

Studies to find a practical substitute for the common bile duct have attracted the interest of many investigators. A wide variety of synthetic materials have been tried and abandoned. Among these are polyethylene, 10,23,24,26 Vitallium, 15,18,26 Monel metal, 19 rubber, silicon, quills, catgut rolls, and absorbable magnesium. 27 In an attempt to find a more physiologic biliary substitute, various homologous tubular structures have been used experimentally. Among these are jejunum, 11,12,31 artery, 17,27,29 vein, 17,20,31 split-thickness skin grafts, 1,8,16,28 fascia, 7,15 bile duct homografts, 14,21 ureter, 17 fallopian tube, and appendix. 27 Varying success has attended these efforts, but most investigators have not advocated clinical application of their methods. 5 The experimental work has made certain points clear. Most free tissues interposed in the common bile duct lose their identity by a process of disintegration and replacement by scar tissue. 21 The cicatrization results in an obstructive biliary stricture which