Vital A, Bioulac-Sage P, Bedin C, Balabaud C
Liver. 1982 Sep;2(3):230-5. doi: 10.1111/j.1600-0676.1982.tb00201.x.
Besides the spontaneous occurrence of portacaval shunts in chronic liver diseases and the performance of shunt to cure portal hypertension, shunts are now proposed for the treatment of some metabolic diseases, especially in children. The portacaval shunt model in the rat, known to induce liver atrophy related to hepatocyte loss and atrophy, was used to investigate morphological liver changes occurring in cholestasis. Two weeks after portacaval or sham portacaval shunt, the bile duct was ligated and livers were examined by light and electron microscopy at 5 h, 20 h, 4 days and 8 days. Portal inflammatory reaction and proliferation of bile ducts were identical but areas of patchy hepatic necrosis were more numerous in shunted rats. Hepatocyte size decreased in the sham group but increased in the other group. Hepatocyte ultrastructural changes were similar in the two groups. At 5 h, the number of bile canaliculi sections increased (X2) and 95% of them were normal. As time elapsed, the ratio of dilated bile canaliculi without microvilli and of bile canaliculi filled with cytoplasmic blebs increased but in no case reached 50% of the total. These results show that in the rat, cholestasis induced by bile duct ligation has approximately the same characteristics in control or shunted animals.
除了在慢性肝病中自然出现的门腔分流以及为治疗门静脉高压而进行的分流手术外，现在有人提出分流术可用于治疗某些代谢性疾病，尤其是儿童的代谢性疾病。大鼠门腔分流模型已知会诱发与肝细胞丢失和萎缩相关的肝萎缩，该模型被用于研究胆汁淤积时肝脏发生的形态学变化。在进行门腔分流或假门腔分流两周后，结扎胆管，并在5小时、20小时、4天和8天时通过光镜和电镜检查肝脏。门脉炎症反应和胆管增生情况相同，但分流大鼠的散在肝坏死区域更多。假手术组肝细胞大小减小，而另一组肝细胞大小增加。两组肝细胞超微结构变化相似。在5小时时，胆小管切面数量增加（X2），其中95%正常。随着时间推移，无微绒毛的扩张胆小管和充满细胞质小泡的胆小管比例增加，但在任何情况下都未达到总数的50%。这些结果表明，在大鼠中，胆管结扎诱导的胆汁淤积在对照动物或分流动物中具有大致相同的特征。
