Abstracts
2002 Digestive Disease Week

# 102494 Abstract ID: 102494 Bovine Pericardium Buttress Prevents Recanalization of Stapled Uncut Small Bowel
John M Morton, Tananchai Lucktong, Timothy Farrell, Chapel Hill, NC

Background: In contrast to traditional Roux-en-Y anatomy, an uncut Roux reconstruction (see figure) provides bilio-pancreatic diversion and preserves myoelectric continuity. Regrettably, previous iterations of the uncut Roux have been plagued by recanalization of the uncut staple line. Our aim was to use bovine pericardium buttress to prevent recanalization of the stapled small bowel partition using a porcine model. Methods: Sixteen female pigs (~30 kg) underwent a side-to-side stapled jejuno-jejunostomy 20 cm distal to the ligament of Treitz, with placement of a non-divided stapled partition (single row, 2.5mm width, Ethicon Endosurgery, Cincinnati, OH) at the midpoint of the 10-cm intervening jejunal loop. Nine animals in the experimental group had a bovine pericardium buttressed staple line (Peri-Strips Dry, Bio-Vascular, Inc., Saint Paul, MN) while seven animals in the control group had a non-buttressed staple line. At 6 weeks postoperatively, necropsy was performed and the primary outcome, staple line recanalization, was assessed grossly and histologically. Statistical analysis was performed by ?2 test. Results: There were no major complications and all animals gained weight. At six weeks, all buttressed uncut staple lines were grossly and histologically intact, while all non-buttressed uncut staple lines had recanalized completely (p<0.05). Conclusion: The use of bovine pericardium buttress will prevent small bowel recanalization of uncut small-bowel staple lines at early follow-up. These results warrant investigation of bovine pericardium for intestinal applications in humans. Future uses might include the uncut Roux-en-Y for gastric bypass, vertical banded gastroplasty, revision of Bilroth II procedures impacted by bile reflux, or reinforcement of enteral staple lines in high-risk settings. Supported by a grant from Bio-Vascular, Inc.