Ooi R C, Luo X Y, Chin S B, Johnson A G, Bird N C
Department of Mechanical Engineering, The University of Sheffield, Mappin Street, Sheffield, S1 3JD, UK.
J Biomech. 2004 Dec;37(12):1913-22. doi: 10.1016/j.jbiomech.2004.02.029.
Clinical studies suggest that the flow of bile in the biliary system may be a contributing factor in the pathogenesis of cholelithiasis, but little is known about its transport mechanism. This paper reports a numerical study of steady flow in human cystic duct models. In order to obtain parametric data on the effects of various anatomical features in the cystic duct, idealised models were constructed, first with staggered baffles in a channel to represent the valves of Heister and lumen. The qualitative consistency of these findings are validated by modelling two of the real cystic ducts obtained from operative cholangiograms. Three-dimensional (3D) models were also constructed to further verify the two-dimensional (2D) results. It was found that the most significant geometric parameter affecting resistance is the baffle clearance (lumen size), followed by the number of baffles (number of folds in the valves of Heister), whilst the least significant ones are the curvature of the cystic duct and the angle between the neck and the gallbladder. The study presented here forms part of a larger project to understand the functions of the human cystic duct, especially the influence of its various anatomical structures on the resistance to bile flow, so that it may aid the assessment of the risk of stone formation in the gallbladder.
临床研究表明，胆汁在胆道系统中的流动可能是胆石症发病机制中的一个促成因素，但对其运输机制知之甚少。本文报道了对人体胆囊管模型中稳定流动的数值研究。为了获得胆囊管中各种解剖特征影响的参数数据，构建了理想化模型，首先在通道中设置交错挡板以代表希斯特瓣和管腔。通过对从手术胆管造影获得的两个真实胆囊管进行建模，验证了这些发现的定性一致性。还构建了三维（3D）模型以进一步验证二维（2D）结果。研究发现，影响阻力的最显著几何参数是挡板间隙（管腔大小），其次是挡板数量（希斯特瓣的褶皱数量），而最不显著的是胆囊管的曲率以及颈部与胆囊之间的角度。本文所呈现的研究是一个更大项目的一部分，该项目旨在了解人体胆囊管的功能，特别是其各种解剖结构对胆汁流动阻力的影响，以便有助于评估胆囊结石形成的风险。
