Effects of glycerol pretreatment upon biliary or venous grafts in bile duct replacement.

With the use of microsurgical procedures, sequential studies have been done to compare the short and long term outcome of the bile duct and the femoral vein as autogenous bioprostheses of the bile duct. Nonpretreated grafts of both types are associated with an early superficial cell loss, either epithelial or endothelial. An initial biliary sludge resulted with further consequences, that in biliary stasis, lithiasis and biliary cirrhosis. Both grafted ducts became epithelialized but were the site of an extensive inflammatory reaction followed by fibrosis within the underlying connective tissue and retraction of the graft. On the contrary, pretreatment of the grafts by immersion in concentrated glycerol allowed the initial cell shedding to occur before implantation. The process of epithelialization and glandular formation was not altered in these conditions, whereas the inflammatory and fibrotic reaction in the duct wall was reduced or absent.