Short Intussusception Valves Prevent Reflux After Jejunal Interposition Bilioduodenal Anastomosis

Short whole circumference and semi‐circumference intussusception valves were created in interposition cholecysto‐jejunal‐duodenal conduits in pigs to determine which method best prevented gastrointestinal reflux into the biliary tract. Following intravenous injection of 99 mTc‐HIDA the time interval for its excretion from the liver and appearance in the duodenum was not different in either whole or semi‐circumference valve animals or in controls without valves. After intragastric administration of 99 mTc‐DTPA the relative radioactivity of gallbladder contents (reflux) in the cohort without valves was significantly higher than in both cohorts with valves. Animals with semi‐circumferential valves in turn had significantly higher levels of nuclide than those with whole circumference valves. Reflux was observed grossly in 100% of animals without valves, in 20% of those with semi‐circumference valves, and in no animals with whole circumference valves. This study indicates that both Whole and semi‐circumference intussusception valves placed in jejunal biliary conduits allow unimpeded flow of bile into the gastrointestinal tract. Whole circumference valves are more effective for prevention of reflux than semi‐circumferential valves.