胆囊间置肝管十二指肠吻合术后胆汁成分的分析  

The analysis of the bile component following interposition of gallbladder between the common hepatic duct and duodenum

作　　者：谢向辉[1] 李龙[1] 薛梅[2] 陈晋杰[1] 张连柱[1] 董瑞安[1] 张金哲[1] 

机构地区：[1]首都医科大学附属儿童医院外科,北京100045 [2]解放军总医院小儿内科

出　　处：《中华实验外科杂志》2000年第1期30-31,共2页Chinese Journal of Experimental Surgery

摘　　要：目的　研究胆囊间置肝管十二指肠吻合术后胆汁成分的改变对发生胆石症的影响。方法家犬 15条。对照组 5条 ,行单纯胆囊穿刺术 ;实验组 10条 ,行胆囊间置肝管十二指肠吻合术 ,术后 3个月再行胆囊穿刺术。术中取全部胆汁行常规检查、胆汁培养及胆汁成分定量测定。结果　胆汁常规检查阴性。实验组 5例培养出大肠埃希菌 ,5例无菌生长。实验组胆汁中总胆汁酸浓度明显增高 (P <0 .0 1) ,胆固醇和总胆红素浓度降低 (P<0 .0 5 ) ,K+、Na+浓度明显降低 (P <0 .0 1)。结论　胆囊间置肝管十二指肠吻合术后胆囊仍具有浓缩功能。术后胆汁中胆固醇浓度、总胆红素浓度和K+、Na+浓度降低 ,导致胆石症发生率下降。Objective\ To investigate the change of the bile and its clinical implication following the gallbladder interposition between the common hepatic duct and duodenum for bile duct reconstruction in animal models. Methods\ This experiment was carried out on 15 dogs. Of them, 5 were subjected to the single gallbladder puncture and 10 received the gallbladder interposition between the common hepatic duct and duodenum, and then underwent the gallbladder puncture 12 weeks after operation. The bile were analyzed including bile routine examination, bile culture, and quantitative determination of the bile components [total bile acid (TBA), cholesterol, total bilirubin (TB) and inorganic salts (Na +, K +) during operation. Results\ All animals were alive at termination of the study. Bile routine examination was negative in the two groups. Esherichia coli was cultured in half of the bile in the experimental group and nothing in the control group. The concentration of TBA in the experimental group was significantly increased as compared with that of control group ( P <0.01), while the concentrations of cholesterol and TB decreased ( P <0.05). The concentrations of K + and Na + were significantly decreased ( P <0.01). Conclusion\ The concentration of TBA was significantly increased after the gallbladder interposition for bile duct reconstruction, suggesting the gallbladder preserved the function of concentration. The concentrations of cholesterol, TB and inorganic salts were decreased, indicating the lower morbidity of cholelithiasis.

关 键 词：胆汁成分 胆结石 肝管 十二指肠 吻合术 

分 类 号：R657.4[医药卫生—外科学]