Repairing Large Duodenal Injuries in Dogs by Expanded Polytetrafluoroethylene Patch

Background

One of the most challenging problems in clinical surgery is management of injured duodenum. In this experimental study, we treated large duodenal defects by an expanded polytetrafluoroethylene (ePTFE, Gore-Tex; W.L. Gore, Elkton, MD) soft-tissue patch and compared it with the jejunal serosal patch.

Materials and methods

A duodenal defect (about 50% of the total circumference) was created in the second portion of the duodenum in 20 dogs. The effectiveness and gross and histological examinations of the ePTFE patch technique was compared with the jejunal serosal patch.

Results

No significant difference was found in early survival rates (90.9% versus 88.9%; P = 0.711). The whole grafted area was covered by neomucosa at the end of the sixth week in all animals with the ePTFE patch. The scar was small; no significant narrowing of lumen was noted and serosal healing was uniformly complete. In histological examination, complete coverage of the ePTFE grafts by neomucosa consisting of columnar epithelium with short villous formations was observed.

Conclusion

Use of the ePTFE patch method is easy, reliable, and comparable to the jejunal serosal patch. It can be used in the treatment of large duodenal defects, which cannot be repaired by duodenorraphy.

Key Words: expanded polytetrafluoroethylene patch, duodenal defects, repair