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时间和胆囊切除术对实验性胆管扩张的影响。一项多影像学评估。

The effect of time and cholecystectomy on experimental biliary tree dilatation. A multi-imaging evaluation.

作者信息

Raptopoulos V, Fabian T M, Silva W, D'Orsi C J, Karellas A, Compton C C, Krolikowski F J, Doherty P, Smith E H

出版信息

Invest Radiol. 1985 May-Jun;20(3):276-86. doi: 10.1097/00004424-198505000-00009.

Abstract

The changes of the biliary tree following distal bile duct obstruction and its release were confirmed by biliary scintigraphy and monitored by serial ultrasonography, computed tomography, and values of serum bilirubin and alkaline phosphatase in 14 mongrel dogs. The degree and rate of biliary dilatation were independent of cholecystectomy. The most rapid rate of extrahepatic dilatation occurred within the first 48 hours, while dilated intrahepatic ducts were first recognized three to six days after obstruction. Following release of the obstruction, the degree and rate of resolution of the biliary dilatation were independent of the duration of ligation (one vs. two weeks) and cholecystectomy. The dilatation resolved slowly. Dilated intrahepatic ducts were recognized for as long as eight to 13 days, while extrahepatic biliary dilatation was still present for 13 weeks, at which time the experiment was terminated. It is postulated that the extrahepatic biliary dilatation will approach a plateau approximately one month after total biliary obstruction. It appears that if the obstruction lasts more than one week, it results in irreversible damage to the elasticity of the extrahepatic ducts. Thus, after release of the obstruction, serial biliary imaging is indicated until a new baseline of the biliary tree diameter has been established.

摘要

通过胆道闪烁显像对14只杂种犬胆总管远端梗阻及其解除后胆道树的变化进行了确认,并通过系列超声检查、计算机断层扫描以及血清胆红素和碱性磷酸酶值进行监测。胆道扩张的程度和速度与胆囊切除术无关。肝外扩张的最快速度出现在最初48小时内,而扩张的肝内胆管在梗阻后三至六天首次被识别。梗阻解除后,胆道扩张消退的程度和速度与结扎持续时间(一周与两周)和胆囊切除术无关。扩张消退缓慢。扩张的肝内胆管长达八至十三天仍可被识别,而肝外胆道扩张在13周时仍存在,此时实验终止。据推测,肝外胆道扩张在完全性胆道梗阻后约一个月将接近平台期。似乎如果梗阻持续超过一周,会导致肝外胆管弹性的不可逆损伤。因此,梗阻解除后,应进行系列胆道成像,直至建立胆道树直径的新基线。

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