Department of Hepatobiliary Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China.
World J Gastroenterol. 2012 Dec 28;18(48):7194-200. doi: 10.3748/wjg.v18.i48.7194.
To investigate the impact of different time points of secondary warm ischemia on bile duct in a rat autologous liver transplantation model with external bile drainage.
One hundred and thirty-six male inbred SD rats were randomly assigned to one of four groups (I-IV) according to the secondary warm ischemia time of 0, 10, 20 and 40 min. A rat model of autologous liver transplantation with continuous external biliary drainage under ether anesthesia was established. Ten rats in each group were used to evaluate the one-week survival rate. At 6 h, 24 h, 3 d and 7 d after reperfusion of the hepatic artery, 6 rats were killed in each group to collect the blood sample via the infrahepatic vena cava and the median lobe of liver for assay. Warm ischemia time of liver, cold perfusion time, anhepatic phase, operative duration for biliary external drainage and survival rates in the four groups were analyzed for the establishment of models.
No significant difference was shown in warm ischemia time, anhepatic phase and operative duration for biliary external drainage among the four groups. Five of the 40 rats in this study evaluated for the one-week survival rate died, including three deaths of severe pulmonary infection in group IV. A significant decrease of one-week survival rate in group IV was noted compared with the other three groups. With the prolongation of the biliary warm ischemia time, the indexes of the liver function assessment were significantly elevated, and biliary epithelial cell apoptosis index also increased. Pathological examinations showed significantly aggravated inflammation in the portal area and bile duct epithelial cell injury with the prolonged secondary warm ischemia time. Microthrombi were found in the micrangium around the biliary tract in some sections from groups III and IV.
The relationship between secondary warm ischemia time and the bile duct injury degree is time-dependent, and 20 min of secondary warm ischemia time is feasible for the study of bile duct injury.
在带外引流胆汁的大鼠自体肝移植模型中，研究不同的二次热缺血时间对胆管的影响。
将 136 只雄性近交 SD 大鼠随机分为四组（I-IV），根据二次热缺血时间为 0、10、20 和 40 分钟。在乙醚麻醉下建立带持续外引流胆汁的大鼠自体肝移植模型。每组 10 只大鼠用于评估一周的生存率。在肝动脉再灌注后 6 h、24 h、3 d 和 7 d，每组处死 6 只大鼠，通过肝下腔静脉和中叶肝收集血样进行检测。分析四组模型的热缺血时间、冷灌注时间、无肝期、外引流胆道手术时间和生存率。
四组热缺血时间、无肝期和外引流胆道手术时间无显著差异。在评估一周生存率的 40 只大鼠中，有 5 只死亡，其中 4 组中有 3 例死于严重肺部感染。与其他三组相比，IV 组一周生存率显著降低。随着胆管热缺血时间的延长，肝功能评估指标显著升高，胆管上皮细胞凋亡指数也升高。病理检查显示，随着二次热缺血时间的延长，门区炎症明显加重，胆管上皮细胞损伤加重。在 III 组和 IV 组的一些切片中发现了胆管周围微脉管中的微血栓。
二次热缺血时间与胆管损伤程度的关系是时间依赖性的，20 分钟的二次热缺血时间可用于研究胆管损伤。
