Nugroho Anung N, Mudigdo Ambar, Soetrisno Soetrisno, Yarso Kristanto Y, Nurwati Ida, Indarto Dono, Pamungkasari Eti P
Doctoral Program of Medical Sciences, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia.
Department of Anatomical Pathology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia.
Narra J. 2025 Apr;5(1):e1873. doi: 10.52225/narra.v5i1.1873. Epub 2025 Feb 10.
Increased incidence of laparoscopic cholecystectomy-related bile duct injuries (BDIs), combined with its risk of serious complications and mortality, highlights the need for a more effective repair technique. Although the use of autologous graft in BDI repair has been promoted, the role of autologous parietal peritoneum remains underexplored. The aim of this study was to evaluate the effect of autologous parietal peritoneum grafts in rabbit models of partial BDI, emphasizing its effect on the expression of cluster of differentiation 68 (CD68) and transforming growth factor-β (TGF-β). An experimental post-test-only design was employed, using 27 male New Zealand rabbits aged 8-10 months. The rabbits were allocated into three groups: control (primary closure), autologous parietal peritoneum graft, and autologous gallbladder graft. Partial BDI measuring 15 × 5 mm were surgically created and repaired according to group assignments. The expression of CD68 and TGF-β were measured via enzyme-linked immunosorbent assay (ELISA), while the anastomosis was pathologically examined through hematoxylin and eosin (H&E) staining on days 3, 7, and 14 post-surgery. Statistical analysis was performed using analysis of variance (ANOVA) followed by Bonferroni post hoc tests. No statistically significant difference was observed in the expression of CD68 or TGF-β among the three treatment groups on days 3, 7, and 14 post-surgery, indicating that the effects of autologous parietal peritoneum graft were comparable to the control and the autologous gallbladder graft in promoting wound healing. Fibroblast density on day 3 was significantly lower in the parietal peritoneum group ( = 0.040), reflecting delayed recruitment, but normalized by day 14, indicating successful integration and remodeling. The study highlights the potential role of autologous parietal peritoneum grafts for BDI.
腹腔镜胆囊切除术相关胆管损伤（BDI）的发生率增加，再加上其引发严重并发症和死亡的风险，凸显了需要一种更有效的修复技术。尽管自体移植物在BDI修复中的应用得到了推广，但自体壁层腹膜的作用仍未得到充分探索。本研究的目的是评估自体壁层腹膜移植在部分BDI兔模型中的效果，重点关注其对分化簇68（CD68）和转化生长因子-β（TGF-β）表达的影响。采用仅进行后测的实验设计，使用27只8至10个月大的雄性新西兰兔。将兔子分为三组：对照组（一期缝合）、自体壁层腹膜移植组和自体胆囊移植组。通过手术制造15×5毫米的部分BDI，并根据分组进行修复。通过酶联免疫吸附测定（ELISA）测量CD68和TGF-β的表达，同时在术后第3、7和14天通过苏木精和伊红（H&E）染色对吻合口进行病理检查。使用方差分析（ANOVA），随后进行Bonferroni事后检验进行统计分析。术后第3、7和14天，三个治疗组之间CD68或TGF-β的表达没有观察到统计学上的显著差异，这表明自体壁层腹膜移植在促进伤口愈合方面的效果与对照组和自体胆囊移植相当。壁层腹膜组术后第3天的成纤维细胞密度显著较低（=0.040），反映出招募延迟，但在第14天恢复正常，表明成功整合和重塑。该研究突出了自体壁层腹膜移植在BDI中的潜在作用。
