胆囊间置肝管十二指肠吻合术的实验研究  

Reconstruction of Biliary Tract:Interposition of Gallbladder Between Common Hepatic Duct and Duodenum in Animal Models

作　　者：李龙[1] 张金哲[1] 陈晋杰[1] 谢向辉[1] 张连柱[1] 董瑞安[1] 王大勇[1] 陈亚军[1] 

机构地区：[1]北京儿童医院小儿外科,100045

出　　处：《中华小儿外科杂志》1997年第6期359-361,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的:探讨胆囊间置肝管十二指肠吻合的可行性。方法:杂种犬15只,其中对照组5只,行胆囊活检术;实验组10只,行胆囊间置肝管十二指肠吻合术。术中和术后3个月测胆囊的静息压力、胆总管的静息压力以及 Oddi 括约肌或胆囊管十二指肠吻合口的通过压力和抗返流压力。行口服碘蕃酸胆囊造影检查。结果:动物全部存活,对照组和实验组术后3个月体重差异不显著。实验组动物术后3个月再次手术中,胆囊充盈,壁薄有弹性,胆汁清亮无食物残渣。胆囊的静息压力由0.91±0.47 kPa 升至1.55±0.56 kPa;胆总管静压1.28±0.39 kPa,Oddi 括约肌通过压3.40±0.89 kPa;胆囊管十二指肠吻合口的通过压力4.35±0.97 kPa,抗返流压力18.99±5.69kPa。再次手术后胆囊持续引流液中未见食物。胆囊造影示:对照组和实验组口服碘蕃酸12小时后,胆囊均显影,但实验组中有2例显影淡。脂肪餐后1小时,胆囊影均消失。结论:胆囊间置肝管十二指肠吻合后,胆囊保留着贮存、浓缩和排泄胆汁的功能,胆囊管远端的括约肌样结构具备有效的抗十二指肠向胆囊内返流的功能。Objective:To investigate the feasibility to interpose the gallbladder between com- mon hepatic duct and duodenum for bile duct reconstruction in animal models.Methods:This ex- periment was carried out on 15 dogs.Of them,the gallbladder interposition between the common hepatic duct and duodenum was performed on 10 and the gallbladder biopsy on 5.A resting pres- sure of gallbladder and an antireflux pressure from duodenum to the interposed gallbladder were measured.The concentration and storage function of the interposed gallbladder were evaluated by oral cistobil cholecystography.Results:All animals were alive at termination of the stucy 12 weeks postoperatively.There was no difference in body weight between the two groups.When the experimental group was reoperated on,the bile in the interposed gallbladder was clear and without food residue.The resting pressure in gallbladder increased from 0.91±0.47 kPa prcoper- ation to 1.55±0.56 kPa postoperation.The anti-reflux pressure from duodenum to the interposed gallbladder was 18.99±5.69 kPa.Postoperative X-ray exams revealed that the interposed gall- bladder pressrved the bile storage,concentration and excretion functions.Conclusions:The inter- position of gallbladder can be used to reconstruct the bile duct and preserve the functions of the gallbladder.

关 键 词：胆囊 胆道重建术 十二指肠吻合 

分 类 号：R657.405[医药卫生—外科学]