Özçay Necdet, Özant Ali, Arslan Kalbim, Özkayalar Hanife, Besim Hasan
Near East University, General Surgery, Nicosia, Cyprus.
Near East University, Pathology, Nicosia, Cyprus.
Turk J Surg. 2020 Sep 28;36(3):256-263. doi: 10.47717/turkjsurg.2020.4564. eCollection 2020 Sep.
This study aimed to evaluate the effect of platelet-rich fibrin (PRF) concentrate on the bile duct anastomosis healing process in rats.
Thirty male Sprague Dawley (SD) rats were used for the study. The animals were allocated into three groups: Group I Control Group (n=10): Anastomosis to the common bile duct (CBD) with a stent. Group II PRF Group (n=10): Anastomosis to the CBD with a stent and covered with PRF. Group III Sham Group (n=10): Preparation of the common bile duct, no anastomosis. The animals were followed up for 1 month, then sacrificed. Study parameters were adhesions around the anastomosis, thickness of the bridging bile duct tissue over the stent, and histopathologic examination of the bridging bile duct tissue.
CBD anastomosis using a stent caused severe adhesion around the anastomosis, bridging bile duct tissues were weak and histopathologically, healing was incomplete in most of the control animals. However, PRF application significantly reduced the adhesions, increased the quality of the bridging bile duct tissues, and caused complete healing histologically.
PRF is an autologous, easily prepared membrane. The present study findings show that PRF prevents local complications and increases the healing capacity of the bile duct after CBD anastomosis. Therefore, it might be a new treatment option for preventing complications following common bile duct anastomosis in liver transplantation patients.
本研究旨在评估富血小板纤维蛋白(PRF)浓缩液对大鼠胆管吻合口愈合过程的影响。
30只雄性Sprague Dawley(SD)大鼠用于本研究。动物被分为三组:第一组对照组(n = 10):用支架行胆总管(CBD)吻合术。第二组PRF组(n = 10):用支架行CBD吻合术并覆盖PRF。第三组假手术组(n = 10):制备胆总管,不进行吻合术。对动物进行1个月的随访,然后处死。研究参数包括吻合口周围的粘连情况、支架上方桥接胆管组织的厚度以及桥接胆管组织的组织病理学检查。
使用支架进行CBD吻合术导致吻合口周围严重粘连,桥接胆管组织薄弱,在大多数对照动物中,组织病理学检查显示愈合不完全。然而,应用PRF可显著减少粘连,提高桥接胆管组织的质量,并在组织学上实现完全愈合。
PRF是一种自体、易于制备的膜。本研究结果表明,PRF可预防局部并发症并提高CBD吻合术后胆管的愈合能力。因此,它可能是预防肝移植患者胆总管吻合术后并发症的一种新的治疗选择。