Use of a Vessel Sealant Device for Cystic Duct Ligation in the Dog. Issue 8 (11th September 2014)

• Record Type: Journal Article
• Authors: Marvel, Sarah; Monnet, Eric
• Is Part Of: Veterinary surgery. Volume 43:Issue 8(2014)
• Page Start: 983
• Page End: 987
• Publication Date: 2014-09-11
• Subjects: Veterinary surgery -- Periodicals; Veterinary Medicine -- Periodicals; Surgery -- Periodicals; Societies, Medical -- Periodicals; 636.0897
• DOI: 10.1111/j.1532-950X.2014.12274.x
• Languages: English
• ISSNs: 0161-3499

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="vsu12274-sec-0001" sec-type="section"> <title>Objective</title> <p>To compare a vessel sealant device to hemostatic clips for cystic duct ligation in a canine cadaveric model.</p> </sec> <sec id="vsu12274-sec-0002" sec-type="section"> <title>Study Design</title> <p>Experimental.</p> </sec> <sec id="vsu12274-sec-0003" sec-type="section"> <title>Methods</title> <p>Hepatobiliary systems were collected from normal dogs. A microtip pressure transducer was inserted into the common bile duct and a 20–24 g intravenous catheter was placed in a hepatic duct. The cystic duct was ligated with 1 of 3 techniques: vessel sealant device (VSD), 10 mm medium Endoclips™, or 10 mm large Endoclips™ with 6 specimens in each group. Methylene blue was infused until failure, which was recorded as seal/clip failure or retrograde movement of methylene blue into the liver.</p> </sec> <sec id="vsu12274-sec-0004" sec-type="section"> <title>Results</title> <p>Mean failure pressure of the medium endoclip group was significantly lower than the large endoclip group (<italic>P</italic> = .014). There was no difference between the failure pressure of the VSD group and the medium and large endoclip groups (<italic>P</italic> = .097, <italic>P</italic> = .34, respectively). Failure by leakage at the cut surface of the cystic duct occurred in 2 specimens in the medium endoclip group while all others failed by retrograde flow of the methylene blue through the hepatic ducts.</p> </sec> <sec id="vsu12274-sec-0005" sec-type="section"> <title>Conclusions</title> <p>The vessel sealant device appears comparable to large endoclips for closure of the cystic duct in an acute cadaveric model, while medium endoclips may not fully compress or span the diameter of a cystic duct in large breed dogs and leak at lower pressures.</p> </sec> </abstract>