In vivo porcine training model of laparoscopic common bile duct repair with T-tube insertion under the situation of iatrogenic common bile duct injury. 2018

Eun Young Kim, and Tae Ho Hong
Department of Trauma and Surgical Critical Care, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

OBJECTIVE We introduce a training porcine model for laparoscopic common bile duct (CBD) repair with T-tube insertion. The model could be the feasible training tool for a surgeon learning hepatobiliary surgery. METHODS Totally laparoscopic CBD repair with T-tube insertion was performed on 9 pigs by 9 trainees naïve in hepatobiliary surgery. Similar to the situation of iatrogenic injury, CBD was transected by laparoscopic scissors at the middle part about 1 cm in length, and the transected CBD was repaired through end-to-end anastomosis with T-tube insertion. A secureness of anastomosis was confirmed by saline leakage test and all animals were sacrificed after the surgery. RESULTS All novice surgeons completed operations successfully without complications. Total mean operative time was 85 ± 1.7 minutes and the mean time spent performing the CBD repair with T-tube insertion was 71 ± 3 minutes. There was no bile leakage after primary anastomosis in all animals. CONCLUSIONS This porcine training model for laparoscopic CBD repair with T-tube insertion could be a feasible and effective training tool for surgeons with little experience in laparoscopic hepatobiliary surgery.

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