Course of the initial epithelial lesions associated with autologous bile duct replacement: Experimental study in rats

Mucosal lesions and healing of the common bile duct were analyzed after various chemical and surgical insults in the rat by means of histologic and scanning electron microscopic investigations. Autogenous bile duct replacement is rapidly associated within the first 72 postoperative hours with complete epithelial cell desquamation, and its precocious consequence is biliary sludge. These lesions also occurred when the bile flow was diverted; the extrinsic devascularization and denervation did not produce extensive epithelial cell loss. Heparin perfusion within the biliary tree or the induction by glycerol of epithelial cell loss before bile duct transplantation is suggested in order to avoid extensive biliary sludge after bile duct transplantation.