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[保留乳头通道的带蒂小肠段用于肝外胆管环形置换。一项动物实验研究]

[Pedicled small intestine segment for circular replacement of the extrahepatic bile duct in preserved papillary passage. An animal experiment study].

作者信息

Böttger T, Weber W, Sorger K, Pickel B, Mann B, Junginger T

机构信息

Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Johannes Gutenberg-Universität, Mainz, BRD.

出版信息

Langenbecks Arch Chir. 1991;376(6):351-8. doi: 10.1007/BF00186428.

Abstract

The effect of a small bowel segment as a extra-hepatic bile duct replacement was examined in 12 pigs followed-up for a period of 420 days. No complications, either during the operation or postoperatively, were observed in any of the animals. The laboratory parameters were within normal range over the entire observation period of 420 days. After 2, 6, and 12 months there was no anastomotic stenosis in the PTC. The intrahepatic biliary tract was not dilated. There was obvious peristalsis of the small bowel transplant towards the papilla of Vater. The autopsy 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 a chronic infection. In the graft as well as in the vascular pedicle the nerve fibres were intact. Liver biopsy showed no pathological changes. In the light of these experiments, a small bowel segment presents a very promising alternative replacement of the extrahepatic biliary tract.

摘要

在12头猪身上研究了小肠段作为肝外胆管替代物的效果,随访期为420天。所有动物在手术期间或术后均未观察到并发症。在420天的整个观察期内,实验室参数均在正常范围内。2个月、6个月和12个月后,经皮肝穿刺胆管造影(PTC)未发现吻合口狭窄。肝内胆管未扩张。小肠移植向 Vater 乳头有明显蠕动。尸检显示移植物已愈合,无任何刺激迹象。组织学上,移植物的结构未受干扰。胆管黏膜和小肠黏膜有明显区别,无慢性感染迹象。移植物和血管蒂中的神经纤维均完整。肝活检未显示病理变化。鉴于这些实验,小肠段是肝外胆管替代物的一个非常有前景的选择。

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