Development a New Biliary Reconstruction Using Antireflux Intestinal Spur Valve

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We conducted this study to establish the best method for construction of intestinal antireflux spur valve which could be beneficial in prevention of ascending cholangitis in cases treated by hepatic portoenterostomy and similar conditions.Materials and Methods :Fourteen Mongrel dogs of both sexes weighing from 10-20Kg were used, among which 2 dogs served as control. For all dogs, a spur valve was constructed by denuding the seromuscular layer of one side of the distal end of the jejunal conduit and then suturing the boundries of the denuded area to the duodenum. The size of the valves was 2cm in 6 dogs, 5cm in 6 dogs and no valve was constructed in the remaining 2 control dogs. Manometric studies, barium studies and histopathological studies were performed.Results :Results were expressed as poor, fair and good. In control dogs there was no valve action and reflux could be observed easily. In dogs with 2cm sized valve 4 out of 6 showed good results and 2 fair. While in dogs with 5cm sized valve 3 out of 6 were good, 2 poor and 1 fair. Opening pressure in fair and good cases ranged from 11 to 20 cmH20. The efficacy of the valve for anti-reflux mechanism was better in later examinations than in earlier ones and it was due to the initial mild inflammatory process within the valve.