应用胆道封堵器选择性肝叶切除的可行性实验研究  

Experimental Study on Selective Hepatic Lobectomy Using Nitinol Alloy Net Blocker of Biliary Intrahepatic Duct

作　　者：谭洪[1] 徐建明[1] 熊先泽[1] 程南生[1] 吴良洪[2] 林圯昕[1] 

机构地区：[1]四川大学华西医院胆道外科,成都610041 [2]成都市第一人民医院外科,成都610041

出　　处：《四川大学学报（医学版）》2010年第4期656-659,共4页Journal of Sichuan University(Medical Sciences)

基　　金：四川省科技厅科技支撑项目(项目合同编号:07JY029-058)资助

摘　　要：目的探讨应用镍钛合金胆道封堵器进行非常规手术选择性肝切除的可行性和作用机理。方法应用有膜及无膜两种胆道封堵器选择性栓塞肝内胆管,通过组织学观察、金属蛋白酶抑制因子-1(TIMP-1)及转化生长因子-β1(TGF-β1)的检查结果初步探讨非常规手术选择性肝切除的可行性和作用机理。结果镍钛合金无膜胆道封堵器通过介入方法置入肝内胆管,能达到安全和满意的非常规手术肝叶切除的效果,无膜胆道封堵器栓堵组TIMP-1和TGF-β1表达均高于对照组(P<0.05)。结论镍钛合金胆道封堵器栓堵肝内胆管可达到选择性肝叶切除的效果,并有望为临床提供一条治疗肝内胆管结石的新方法。Objective To investigate the feasibility and possible mechanism of non traditional hepatic lobectomy using nitinol alloy net blocker of biliary intrahepatic duct.Methods Biliary intrahepatic ducts of the experimental pigs were blocked with and without dissepiment blockers.The histological changes and expressions of TGF-β1 and TIMP-1 in the livers were compared.Results Blockage of biliary intrahepatic duct using nitinol alloy net blocker without dissepiment resulted in obvious atrophy of the focus liver.The mean weight and size of the focus liver was only 1/4 of the controls(P<0.05),with liver cells almost completely taken by collagen fibers.Higher expressions of TGF-β1 and TIMP-1 were found in the group without dissepiment than in the group with dissepiments(P<0.05).Conclusion Using nitinol alloy net blocker for selective hepatic lobectomy is as effective as traditional hepatic lobectomy.It may offer a new way for treating intrahepatic bile duct stones.

关 键 词：肝内胆管结石 肝切除术 镍钛合金胆道封堵网 

分 类 号：R657.3[医药卫生—外科学]