Feasibility of using the homologous parietal peritoneum as a vascular substitute for venous reconstruction during abdominal surgery: An animal model

Abstract

Background: The interest in vascular substitutes has recently increased. We evaluated the feasibility of using a homologous parietal peritoneum as a vascular substitute for venous reconstruction during abdominal surgery. Methods: The inferior vena cava was replaced with a homologous parietal peritoneum after cross-linking with glutaraldehyde in 36 rabbits. At 7, 14, and 28 days, the patency rate, outer and inner graft diameters, histology, and immunohistochemistry were evaluated. Results: Both the 7-and 14-day groups maintained vascular patency. Vascular patency was maintained in 3 rabbits in the 28-day group. The inner diameters of the anastomotic sites were 6.23 ± 0.18, 5.64 ± 0.16, and 2.34 ± 0.21 mm in the 7-day, 14-day, and 28-day groups, respectively. The midpoint inner diameters of the homologous parietal peritoneum grafts were 624 ± 0.46, 5.74 ± 0.26, and 2.14 ± 0.28 mm in each group, respectively. Endothelial cell proliferation on the homologous parietal peritoneum graft surfaces in all groups was based on the histological findings from the first group. Multiple neovascularizations of the homologous parietal peritoneum graft were found in the 14-and 28-day groups, indicating neomedia formation. Acute inflammation appeared to progress to the entire layer of the homologous parietal peritoneum graft without an intraluminal thrombus, but the graft was patent in the 14-day group. In the 28-day group, 6 rabbits showed near-total occlusion and a thrombus formed in the homologous parietal peritoneum graft at the anastomosis site with severe stricture; however, the rabbits were alive and had collateral vessel formation. Conclusion: Using homologous parietal peritoneum is feasible for venous reconstruction in abdominal surgery.

Total portal vein replacement with peritoneal interposition graft during Whipple’s procedure for extrahepatic cholangiocarcinoma: a technical report

“…Cryopreserved veins (e.g., femoral vein) allografts from deceased donors are a valid alternative option. However, because of frequent shortage of donors and limited availability outside transplant centers, their use is limited [ 10 ]. In summary, numerous vascular substitutes are potentially available upon careful evaluation of their inherent disadvantages.…”

Progress and Current Limitations of Materials for Artificial Bile Duct Engineering

“…The classic surgical repair and anastomosis techniques for BDI and post-injury stenosis, such as bile duct repair with T-tube drainage, end-to-end bile duct anastomosis with T tube drainage, and Roux-en-Y bile duct jejunostomy, often result in high frequency of postoperative complications and high recurrence rates of stenosis [ 7 , 8 ]. Autologous tissue transplantation repair methods, such as using autologous vascularized gallbladder valve, gastrointestinal valve, umbilical vein valve, etc., have received extensive attention and development [ 9 , 10 , 11 ]. However, these treatment solutions require further investigation and evaluation due to the “repairing trauma with trauma” concept of donor tissue co-morbidity and the inconclusive data regarding long-term effects.…”