Sisić F, Hamamdzić M, Krnić J, Stevancević M, Duzić E
Vojna bolnica, Sarajevo Hirursko odelenje, Veterinarski fakultet, Sarajevo.
Acta Chir Iugosl. 1990;37(2):167-80.
Experiments were carried out on 25 grown-up dogs of both sex in general anesthesia. The supraduodenal part of the choledochus was excised and the reconstruction of the defect with a free venous autograft was made by an end to end anastomosis without use of a transitory or permanent prosthesis. The experimental animals were observed for 60 days, during which period they were checked clinically, biochemically and radiologically. After this period the animals were sacrificed and surgical peroperative control and sampling of material for histological study were made. Out of 25 experimental animals 18 (72%) survived a period of 60 days and 7 dogs died. On autopsy it was found that the cause of death in all animals was biliary peritonitis, but in only one case due necrosis of the graft. The values of bilirubin concentration at the end of the experiment showed almost normal level, but the values of the alkaline phosphate activity and transminase showed significant increased values. Intravenous biligraphy showed significant excretion of the contrast material, freely passing the graft, which was dilated due to stenotic changes of the distal anastomosis. After sacrificing the animals we found: the graft increased length, diameter, thickness wall and stenosis of the distal anastomosis. By histological exploration we found in the liver the signs of the biliary stasis and in the grafts substitution of its endothelium by biliary epithelium. Free venous autograft used as a substitute in the reconstruction of the bile duct which survived 60 days postoperatively, remained transient but with changes in the sense of elongation and dilatation caused by the stenosis od distal anastomosis. Histologically the grafts were entirely bridged by biliary epithelium.
在全身麻醉下对25只成年雌雄犬进行了实验。切除胆总管十二指肠上段，采用游离自体静脉移植，通过端端吻合重建缺损，未使用临时性或永久性假体。对实验动物进行了60天的观察，在此期间对它们进行了临床、生化和放射学检查。60天后处死动物，进行手术中的操作对照并采集材料进行组织学研究。25只实验动物中，18只（72%）存活了60天，7只死亡。尸检发现，所有动物的死亡原因都是胆汁性腹膜炎，但只有一例是由于移植物坏死。实验结束时胆红素浓度值显示几乎正常，但碱性磷酸酶活性和转氨酶值显著升高。静脉胆道造影显示造影剂有明显排泄，可自由通过移植物，由于远端吻合口狭窄改变，移植物扩张。处死动物后我们发现：移植物长度增加、直径增大、壁增厚以及远端吻合口狭窄。通过组织学检查，我们在肝脏中发现了胆汁淤积的迹象，在移植物中发现其内皮被胆管上皮替代。用作胆管重建替代物的游离自体静脉移植在术后存活了60天，仍然是临时性的，但因远端吻合口狭窄而出现伸长和扩张的变化。组织学上，移植物完全被胆管上皮覆盖。
