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使用空肠管进行胆道重建:犬类实验研究

Biliary tract reconstruction using jejunal tube: an experimental study in dogs.

作者信息

Trentini Eliane Anrain, Crema Eduardo, Llanos Juan Carlos, Lerco Mauro Masson, Magna Luiz Alberto, Leonardi Luiz Sergio

机构信息

State University of Campinas, Faculty of Medical Sciences, Department of Surgery, 17017-240-Bauru-SP-Brazil.

出版信息

Hepatobiliary Pancreat Dis Int. 2009 Apr;8(2):179-85.

Abstract

BACKGROUND

To physiologically reconstruct the biliary tract, Crema et al suggested the application of the Monti principle to the biliary tract, already used in humans for the urinary tract. With this technique, a jejunal segment is transversely retubularized. This study aimed to evaluate the efficacy of jejunal tube interposition between the common bile duct and duodenum in dogs.

METHODS

Thirteen dogs underwent a laparoscopic common bile duct ligature, followed by a biliodigestive connection by jejunal tube interposition after one week. The levels of glutamic-pyruvic and glutamic-oxalacetic transaminases, total bilirubins, alkaline phosphatase and gamma-glutamyltransferase were assessed before surgery and thereafter weekly until euthanasia, which was performed 6 weeks after biliodigestive connection.

RESULTS

Data on 9 dogs were analyzed statistically. The dogs presented with obstructive jaundice after common bile duct ligature, as confirmed by biochemical examination. They showed a statistically significant reduction in cholestasis after biliodigestive connection by jejunal tube interposition and were healthy until the end of the experiment.

CONCLUSION

A statistically significant reduction was seen in total bilirubin and canalicular enzymes (alkaline phosphatase and gamma-glutamyltransferase) in the 9 dogs 6 weeks after biliodigestive connection by jejunal tube interposition.

摘要

背景

为了从生理角度重建胆道,克雷马等人建议将已用于人体泌尿道的蒙蒂原理应用于胆道。采用这种技术时,将一段空肠横向重新形成管状。本研究旨在评估犬胆总管与十二指肠之间置入空肠管的疗效。

方法

13只犬接受腹腔镜胆总管结扎术,1周后通过置入空肠管建立胆肠连接。在手术前以及此后每周评估谷丙转氨酶、谷草转氨酶、总胆红素、碱性磷酸酶和γ-谷氨酰转移酶水平,直至实施安乐死,安乐死在胆肠连接术后6周进行。

结果

对9只犬的数据进行了统计学分析。胆总管结扎术后犬出现梗阻性黄疸,生化检查证实了这一点。通过置入空肠管建立胆肠连接后,犬的胆汁淤积有统计学意义的降低,并且直到实验结束时均健康。

结论

在通过置入空肠管建立胆肠连接6周后,9只犬的总胆红素以及小管酶(碱性磷酸酶和γ-谷氨酰转移酶)有统计学意义的降低。

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