自体静脉段移植修复胆管缺损的实验研究  

Transplantation of autologous vein graft in the repair of bile duct defect:an experimental study

作　　者：刘会春[1] 张培新[1] 崔培元[1] 鲁贻民[1] 周磊[1] 吴华[1] 

机构地区：[1]蚌埠医学院第一附属医院,蚌埠233004

出　　处：《中华普通外科学文献（电子版）》2007年第3期146-149,共5页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的探讨胆管缺损的修复材料和方法。方法本地白山羊40只随机分成4组,每组10只,A组、B组、C组分别整段切除2、3、4 cm的胆总管,缺损通过移植相应长度内置硅胶管的自体大隐静脉进行修复,移植物周围以带蒂大网膜包裹,同时切除胆囊;D组为对照组,仅行胆囊切除及胆管周围松动。观察各组动物的活动情况、黄疸及排便情况,分析意外死亡的原因,分别记录术前、术后1、3、6个月血生化变化,在术后6个月处死动物观察移植血管的病理改变。结果A组、B组、D组三组动物各组内部术前及术后1、3、6个月各时间点血生化检查结果,各组之间术前及术后1、3、6个月各时间点血生化检测无显著性差异;A组、B组、C组所移植血管存活情况有差异。A组与B组、C组比较差异有统计学意义(P<0.001)。结论山羊采用自体大隐静脉段移植加内支架并带蒂大网膜包裹来修复胆管短段(<3 cm)缺损是可行的,进一步的实验研究对指导临床具有重要意义。Objective To explore the repairing material and operational skill for bile duct defect.Methods 40 local healthy hybrid goats were divided randomly into 4 group.In group A,B,C,Excision of a segmental duct(2cm,3cm,4cm at length respectively) was performed to establish bile duct injury models.Autologous vein segment with a stent was used to repair the common bile defects.Finally the vein graft was covered with vascularized great omentum.Bladders in all animals were excised.Cholecystectomy and a circular mobilization of the common bile duct were conducted in group D.Animals' postoperative performance status,blood biochemical examination on operative day and postoperative months 1,3 and 6 were studied.Six months after the operation the animals were killed and histopathological change in the vein grafts was observed.Results No notable changes in blood biochemistry postoperatively.The typical columnar epithelium of the common bile duct was seen in the vain graft.There were much difference of postoperative performances of vein grafts performances after operation among A and B,C groups.Conclusion Transplantation of autologous great saphenous vein graft and stent covered by vascularized great omentum to repair common bile duct(CBD) injuries may be feasible and alternative in the goats.Further experimental studies should be carried out to validate these findings,which will help to clinical application.

关 键 词：自体大隐静脉段 内支架 胆总管 修复 

分 类 号：R657.4[医药卫生—外科学]