Trentini Eliane Anrain, Crema Eduardo, Llanos Juan Carlos, Lerco Mauro Masson, Magna Luiz Alberto, Leonardi Luiz Sergio
State University of Campinas, Faculty of Medical Sciences, Department of Surgery, 17017-240-Bauru-SP-Brazil.
Hepatobiliary Pancreat Dis Int. 2009 Apr;8(2):179-85.
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.
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.
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.
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.
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。
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。
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。
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。
