胆管损伤早期内置支架并Ⅰ期修复的实验研究  

Experimental study of early placing stent in common bile duct and primary repair after common bile duct injury

作　　者：黎武[1] 孙权[1] 

机构地区：[1]武汉大学中南医院普外一科,天门市第一人民医院430071

出　　处：《临床外科杂志》2008年第8期535-537,共3页Journal of Clinical Surgery

摘　　要：目的探讨胆管损伤早期内置支架并Ⅰ期修复对术后远期胆管狭窄的预防作用及其临床应用价值。方法用36只日本大耳白兔建立胆管损伤模型,将其分为三组,A组:内置支架并Ⅰ期修复组(n=12),B组:支架拔除组(n=12),C组:单一Ⅰ期修复组(n=12)。观察手术后不同时间点各组动物血碱性磷酸酶、转氨酶及胆管壁胶原含量变化情况,并对胆管壁进行HE及Mas-son染色做病理学检查。结果C组在术后各时间点血碱性磷酸酶、转氨酶及胶原含量均与A组差异有统计学意义(P<0.05);B组术后2个月时上述指标与A组差异有统计学意义(P<0.05);术后4个月时差异无统计学意义(P>0.05)。结论胆管损伤早期内置支架并I期修复具有预防术后远期胆管狭窄的作用,但过早拔除支架可能会导致狭窄的发生。Objective To explore the preventive effect of early placing stent in common bile duct （CBD） and primary repair after common bile duct injury on the long - term stricture of bile duct postoperation and its chnical value. Methods In an animal model,36 Japanese rabbits underwent simulated common bile duct injuries and then randomly divided into 3 groups： group A, stent inserted in CBD with primary repair （n = 12） ; group B, stent extracted from CBD （n = 12）, and group C, primary repair only （n = 12）. The changes in alkaline phosphatase （ALP）, alanine aminotransferase （ALT） and collagen content in bile duct at different time points after operation were observed. The pathological changes in bile duct tissue were studied by HE and Masson staining. Results There was statistically significant difference between group A and group C in ALT, ALP and collagen content in bile duct at different time points after operation （P 〈 0.05 ）. At second month after operation, there was significant difference in the above - mentioned indexes between group A and group B （ P 〈 0.05 ）, but there was no significant difference at 4th month after operation （P 〉 0.05 ）. Conclusion Early placing stent in common bile duct and primary repair after common bile duct injury can prevent the late stricture of bile duct postoperation; However,extracting stent too early probably leads to the stricture of bile duct.

关 键 词：胆管损伤 支架 狭窄 修复 

分 类 号：R657.4[医药卫生—外科学]