Böttger T C, Junginger T
Department of General and Abdominal Surgery, Johannes Gutenberg-University, Mainz, Germany.
Arch Surg. 1992 Dec;127(12):1424-7; discussion 1428. doi: 10.1001/archsurg.1992.01420120058010.
The effect of a small-bowel segment as a total extrahepatic bile duct replacement, with preservation of the bile passage through the papilla of Vater, was examined in 12 pigs followed up for 420 days. No complications during or after surgery were observed in any of the animals. The laboratory parameters were within normal range during the entire observation period. No anastomotic stenosis was evident on percutaneous transhepatic cholangiography in animals examined 2, 6, or 12 months after surgery. The intrahepatic biliary tract was not dilated. There was obvious peristalsis of the grafted small-bowel toward the papilla of Vater. Autopsies showed that the grafts had healed without any sign of irritation. Histologically, the structure of the graft remained undisturbed. There was a clear distinction between the mucosa of the bile duct and that of the small bowel, with no sign of chronic infection. In the graft as well as in the vascular pedicle, the nerve fibers were intact. Liver biopsy showed no pathologic changes. In light of the results of these experiments, the small-bowel segment appears to be a very promising substitute for the injured extrahepatic biliary duct.
在12头猪身上进行了研究，将一段小肠作为完全肝外胆管替代物，并保留通过十二指肠乳头的胆汁通道，随访420天。所有动物在手术期间及术后均未观察到并发症。在整个观察期内，实验室指标均在正常范围内。术后2个月、6个月或12个月接受检查的动物，经皮经肝胆管造影未发现吻合口狭窄。肝内胆管未扩张。移植的小肠明显向十二指肠乳头蠕动。尸检显示移植物已愈合，无任何刺激迹象。组织学检查显示，移植物的结构未受干扰。胆管黏膜与小肠黏膜有明显区别，无慢性感染迹象。在移植物和血管蒂中，神经纤维完整。肝活检未发现病理变化。根据这些实验结果，小肠段似乎是受损肝外胆管非常有前景的替代物。
