Spiegel H U, Schleimer K, Kranz D, Diller R
Department of General Surgery, Westfälische Wilhelms University, Münster, Germany.
Eur Surg Res. 1997;29(6):421-8. doi: 10.1159/000129553.
The aim of the present study is to investigate the impact of bile duct reconstruction by a splint technique, a method which has not been sufficiently researched in animals after liver transplantation. Three experimental groups were set up: I = control, sham operation; II = bile duct reconstruction; III = orthotopic rat liver transplantation (ORLT). After bile duct reconstruction, serum levels of ASAT and ALAT in group II revealed a peak on the first postoperative day. The transplanted animals (group III) showed a second peak in liver enzyme levels on the fifth postoperative day; it was significantly higher than in group II. Serum bilirubin was more elevated in the transplant group, with a peak on day 7. Morphological investigations at the end of surgery revealed only intralobular necrosis and reactive changes in the liver capsule (group II); after transplantation (group III), there was also interstitial and intracellular edema, fatty degeneration and disintegration of the sinusoidal lining. One month later, necrosis, bile duct proliferation, cholestasis, cholangitis and vascular alterations were found in groups II and III. Furthermore, an increased rate of hepatocellular and bile duct proliferation was observed. These findings are partly due to the bile duct reconstruction. We recommend that a bile duct reconstruction control group should be included in ORLT experiments.
本研究的目的是调查夹板技术进行胆管重建的影响，该方法在肝移植后的动物中尚未得到充分研究。设立了三个实验组：I = 对照组，假手术；II = 胆管重建；III = 原位大鼠肝移植（ORLT）。胆管重建后，II组血清谷草转氨酶（ASAT）和谷丙转氨酶（ALAT）水平在术后第一天出现峰值。移植动物（III组）在术后第五天肝酶水平出现第二个峰值；明显高于II组。移植组血清胆红素升高更明显，在第7天达到峰值。手术结束时的形态学检查显示，肝脏仅出现小叶内坏死和肝包膜反应性改变（II组）；移植后（III组），还出现间质和细胞内水肿、脂肪变性以及肝血窦内衬崩解。一个月后，II组和III组均出现坏死、胆管增生、胆汁淤积、胆管炎和血管改变。此外，观察到肝细胞和胆管增生率增加。这些发现部分归因于胆管重建。我们建议在ORLT实验中应设立胆管重建对照组。
