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带蒂空肠移植胆管重建术(作者译)

[Bile duct reconstruction with pendunculate jejunal grafts (author's transl)].

作者信息

Dragojevic B, Landes T, Horsch S, Pichlmaier H, Bohr M

出版信息

Langenbecks Arch Chir. 1978 Oct 16;346(3):167-76. doi: 10.1007/BF01261239.

Abstract

A pedunculate patch, obtained from a disconnected segment of jejunum, was implanted into the longitudinal incision of the ductus choledochus. Intra-operatively, the findings were based upon direct cholecystocholangiography; postoperatively, upon laboratory tests. After an observation period of 12 months a new cholangiography of the transplant was made along with a selective picture of the mesenteric arteries. The choledochus duct with the transplant was examined histologically. Three dogs died immediately postoperatively of peritonitis due to suture insufficiency. Five dogs died of invaginate ileus. These animals, as well as the remaining 8 dogs showed macroscopically and microscopically a smooth and uneventful healing of the transplant at the end of the observation period. Radiographies showed free flow of the biliary duct system. The selective mesenteric arteriographies evidenced beginning anastomosis between the transplant and the capillaries of the bile duct. Based on the results presented, the pedunculate jejunal graft can be considered well suited as an expansion graft for the bile duct.

摘要

从一段游离的空肠获取带蒂补片,将其植入胆总管的纵行切口处。术中,通过直接胆囊胆管造影进行观察;术后,则依据实验室检查结果。经过12个月的观察期后,对移植部位进行了新的胆管造影,并拍摄了肠系膜动脉的选择性图像。对带有移植补片的胆总管进行了组织学检查。3只狗术后因缝合不充分导致腹膜炎而立即死亡。5只狗死于套叠性肠梗阻。在观察期结束时,这些动物以及其余8只狗在宏观和微观上均显示移植部位愈合顺利。X线片显示胆管系统通畅。选择性肠系膜动脉造影显示移植补片与胆管毛细血管之间开始形成吻合。基于所呈现的结果,带蒂空肠移植物可被认为非常适合作为胆管的扩张移植物。

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