BILIODIGESTIVE ANASTOMOSES: A NEW LOOK AT OLD PROBLEM

One of the most urgent problems in surgery is the treatment of biliary tract diseases. Multiple attempts are being made to improve the techniques of mechanical and manual anastomoses. Despite this, it is not possible to overcome the negative aspects of connecting methods of hollow organs. Suture threads and metal clips lengthen the period of tissue regeneration. The wound channels formation promotes the penetration of intestinal microflora into the large intestine wall, contributes to the development of an acute purulent inflammatory reaction in the early stages after surgery and leads to subsequent scar stenosis of the anastomosis. The experiments were performed on 26 animals in order to develop and study a method for the areflux biliodigestive anastomosis formation. All animals are divided into 2 groups. In the first group, experimental animals underwent compression choledochojejunoanastomy using a titanium nickelide device (13 animals). Animals of the second group were subjected to compression cholecystojejunostomy using the same device (13 animals). In experiment were studied the mechanical and biological strength of anastomoses, the time of compression devices rejection, the primary patency of anastomoses, and the morphogenesis of the compression seam. There were no complications associated with the use of a compression device. Seamless compression anastomoses are mechanically and biologically sealed. All dogs had no compression devices in the abdominal cavity to the ninth day. Primary patency of compression valvular anastomoses was preserved in all periods of the experiment. According to the results of histological studies, the inflammatory reaction proceeds with minimal reactive changes in the layers of the anastomosis and is short-term. Histological studies have shown the healing of compression anastomoses occurs according to the type of primary tension and has significant advantages over manual suture.

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