Dias Miguel Angel, Ceneviva Reginaldo, Elias Jorge, Zucoloto Sergio, Baldo Caroline Floreoto, Evora Paulo Roberto Barbosa
Department of Surgery and Anatomy, Ribeirão Preto Faculty of Medicine, University of São Paulo, SP, Brazil.
Acta Cir Bras. 2008;23 Suppl 1:2-7; discussion 7. doi: 10.1590/s0102-86502008000700002.
To evaluate liver alterations caused by biliary obstruction and drainage.
Thirty-nine male Wistar rats were randomly distributed in 4 groups: BO (n=18) bile duct ligation for 20 days, with a periodic evaluation of liver histological alterations, Doppler echography portal flow and measurements of NO and malondialdehyde (MDA); BO/DB (n=13) bile duct occlusion for 20 days followed by biliary drainage by choledochoduodenal anastomosis, 5 days follow-up, same BO group parameters evaluations; group CED (n=4) sham operation and portal flow evaluation trough 20 days; CHB (n=4) sham operation, with hepatic biopsy on 25th day and followed-up trough 25 days, by the same parameters of group BO, with exception of portal flow. Direct bilirubin (DB) and alkaline phosphatase (AP) were evaluated in the group BO, BO/DB and CHB.
The bile duct ligation led to an increase of DB and AP, development of liver histological alterations, reduction of portal flow and increase of plasmatic NO and of MDA levels. The bile duct clearing resulted in a reduction of DB, AP, NO, MDA histological alterations and increase of portal flow.
The biliary occlusion resulted in cholestasis and portal flow reduction, besides the increase of plasmatic NO and of hepatic MDA levels, and histological liver alterations, with a tendency of normalization after the bile duct clearing.
评估胆管梗阻及引流所引起的肝脏改变。
39只雄性Wistar大鼠随机分为4组：胆管结扎组（BO，n = 18），胆管结扎20天，定期评估肝脏组织学改变、多普勒超声门静脉血流以及一氧化氮（NO）和丙二醛（MDA）的测量值；胆管结扎/引流组（BO/DB，n = 13），胆管结扎20天，随后行胆总管十二指肠吻合术进行胆管引流，随访5天，评估与BO组相同的参数；假手术及门静脉血流评估组（CED，n = 4），假手术，持续20天评估门静脉血流；慢性乙肝组（CHB，n = 4），假手术，在第25天行肝活检，并随访25天，评估参数与BO组相同，但不包括门静脉血流。在BO组、BO/DB组和CHB组中评估直接胆红素（DB）和碱性磷酸酶（AP）。
胆管结扎导致DB和AP升高，肝脏组织学改变，门静脉血流减少，血浆NO和MDA水平升高。胆管通畅后DB、AP、NO、MDA水平降低，组织学改变减轻，门静脉血流增加。
胆管梗阻除了导致血浆NO和肝脏MDA水平升高以及肝脏组织学改变外，还会引起胆汁淤积和门静脉血流减少，胆管通畅后有恢复正常的趋势。
