Böttger T, Mann B, Pickel B, Weber W, Sorger K, Junginger T
Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Johannes Gutenberg-Universität, Mainz, Bundesrepublik Deutschland.
Langenbecks Arch Chir. 1991;376(2):77-84. doi: 10.1007/BF01263464.
A pedicle graft of the jejunum can in some cases enlarge a bile duct stricture. The enlargement of the patch and its consequences on the liver function are possible problems. In an animal experiment the following questions were sought. 1) Is a partial replacement of the bile duct with a pedicle graft of small bowel possible? 2) Is there an enlargement of the patch in every case and what are the consequences on the biliary tract and on liver function. The experiments were performed on 14 minipigs over a long-term observation period of 450 days. The red and white blood cell count, the GPT, GOT, GPT, bilirubin and alkaline phosphatase and copper were checked monthly. After 2, 6 and 12 months the intra- and extrahepatic biliary tract were visualized via a PTC. After 8 months an angiography of the pedicle graft was performed. 15 months later the animals were killed and the bile duct, the graft and the liver were histologically examined. 1) With a pedicle graft of small bowel a partial replacement of the extrahepatic bile duct is possible. 2) An enlargement of the patch is seen in every case. The enlargement is a consequence of tension at the pedicle. After 15 months no morphological changes were observed at the patch nor were there any irregularities in liver function.
空肠带蒂移植在某些情况下可扩大胆管狭窄。补片的扩大及其对肝功能的影响可能是问题所在。在一项动物实验中,探讨了以下问题。1) 用小肠带蒂移植部分替代胆管是否可行?2) 是否每种情况下补片都会扩大,以及对胆道和肝功能有何影响。实验在14只小型猪身上进行,观察期长达450天。每月检查红细胞和白细胞计数、谷丙转氨酶(GPT)、谷草转氨酶(GOT)、胆红素、碱性磷酸酶和铜。在2、6和12个月后,通过经皮肝穿刺胆道造影(PTC)观察肝内和肝外胆道。8个月后对带蒂移植进行血管造影。15个月后处死动物,对胆管、移植组织和肝脏进行组织学检查。1) 用小肠带蒂移植可以部分替代肝外胆管。2) 每种情况下都可见补片扩大。扩大是由于蒂部的张力所致。15个月后,补片未观察到形态学变化,肝功能也无异常。