Biliodigestive anastomoses and hepatobiliary functional scintiscans (HBFS) - evaluation of various techniques and the value of HBFS

Objectives of this study in minipigs were the following: 1. What is the value of HBFS in the functional evaluation of biliodigestive anastomoses? 2. Are there any qualitative, functional differences between 3 biliodigestive anastomotic techniques, namely the choledochoduodenostomy (CD), choledochojejunostomy Y-en-Roux (YR), and the choledochojejunoduodenostomy with a pedicled conduit (CJ)? The experimental investigations were performed on healthy adult minipigs that were assigned to 5 different experimental groups. Results: Every animal was clinically asymptomatic, all laboratory tests were negative. Duodenogastric reflux was slightly elevated following CE, no difference was noted after biliodigestive anastomoses. HBFS, that is IBTT, prove an unphysiological delay of bile flow over the D. choledochus as well as over the small intestite proximal and distal to the anastomosis in the CD, YR and CJ group. This delay is significant on a 1%-level in the CJ group. Moreover, this technique is significantly worse (p<0.05) than YR and CD. The clinical Consequences of these results are discussed. (orig.)