Capitanich Pablo, Herrera Javier, Iovaldi Mario L, Balbuena Roque, Casas Gabriel, Malizia Patricio, Bun Maximiliano, Mezzadri Norberto
Departments of Surgery, Hospital Alemán, C1118ATT Buenos Aires, Argentina.
J Gastrointest Surg. 2005 Mar;9(3):369-73. doi: 10.1016/j.gassur.2004.09.024.
The repair of common bile duct injuries is a complex procedure with a significant rate of postoperative morbidity and mortality. The aim of this study was to demonstrate the usefulness of the autologous vein graft in replacement of the bile duct. Twelve male Sprague-Dawley rats weighing 350+/-550 g were used in the study and were divided at random into two groups: the control group (60) and the experimental group in which a 3-mm segment of the bile duct was resected and the biliary tract was replaced by a segment of vein aided by stent (G1). Both groups were subdivided into pairs of rats to study at 30, 60, and 120 days. All of the animals underwent radioisotope cholangiography, a repeat laparotomy, and blood tests for further pathologic study. The clinical evaluation and biochemical nuclear medicine and pathologic studies showed no evidence of cholestasis. The histologic study of the graft showed replacement of the endothelium by biliary-appearing epithelium. The use of an autologous vein graft with a supporting stent proves to be a feasible and alternative procedure for bile duct reconstruction. Further experimental studies should be carried out to validate these findings so they can be implemented in clinical cases.
胆总管损伤的修复是一个复杂的手术，术后发病率和死亡率较高。本研究的目的是证明自体静脉移植替代胆管的有效性。本研究使用了12只体重为350±50克的雄性Sprague-Dawley大鼠，随机分为两组：对照组（6只）和实验组，实验组切除3毫米长的胆管段，并用带支架的静脉段替代胆道（G1）。两组均分为大鼠对，分别在30天、60天和120天进行研究。所有动物均接受放射性核素胆管造影、再次剖腹手术和血液检查，以进行进一步的病理研究。临床评估、生化核医学和病理研究均未发现胆汁淤积的证据。移植组织的组织学研究显示，内皮被胆管样上皮替代。使用带支撑支架的自体静脉移植证明是一种可行的胆管重建替代方法。应进行进一步的实验研究以验证这些发现，以便将其应用于临床病例。
