膨体聚四氟乙烯补片修复胆管缺损的实验研究  

EXPERIMENTAL STUDY ON REPAIR OF BILE DUCT DEFECTS WITH EXPANDED POLYTETRAFLUOROETHYLENE

作　　者：任为[1] 时德[1] 

机构地区：[1]重庆医科大学附属第一医院普外科,重庆400016

出　　处：《中国修复重建外科杂志》2001年第5期305-307,共3页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：重庆市科委中青年科技专家基金 ( 99-4 4 -38)~~

摘　　要：目的　探讨膨体聚四氟乙烯 (e PTFE)修复胆管缺损的可能性。方法　 36条重庆地区成年犬 ,通过切除部分胆管壁 (A组 ,14条 )、整段切除 2～ 4cm胆总管 (B组 ,10条 )和完全结扎胆总管 (C组 ,5条 ;D组 ,7条 )的方式建立胆管损伤模型 ,分别采用 e PTFE补片修补胆管缺损 ,管形材料替代胆管 ,间置材料在胆囊、十二指肠或空肠吻合修复胆管。观察动物在手术前后的活动状况 ,结合胆道造影了解胆管的通畅情况 ,并在术后 3天 ,2、4、8、12及 5 2周切取胆管修复处的组织 ,观察胆管组织的变化 ,不同手术方式对肝脏形态结构的影响。结果　 A组采用e PTFE补片修补胆管 ,胆管上皮能覆盖材料表面 ,通畅率达 75 % (9/ 12 ) ,胆汁引流通畅 ,肝脏无损害 ;B组通畅率为 40 % (4/ 10 ) ,伴有不同程度的肝脏形态结构改变 ;C组和 D组的材料均被排除 ,形成胆囊十二指肠或胆囊空肠瘘。结论　 e PTFE补片具有操作简便、通畅率高的特点 ,可作为修补胆管缺损的材料。Objective To explore the possibility of repair of the extensive bile duct injuries with expanded polytetrafluoroethylene (ePTFE). Methods A total of 36 local healthy hybrid dogs were employed to establish bile duct injury models by means of partial removal of bile duct (group A,14 dogs),excision of a segmental duct(group B,10 dogs), and ligation of the lower part of common bile duct(group C,5 dogs; group D,7 dogs). Group A were patched with ePTFE mesh, group B replaced by ePTFE tube. Interposition of the grafts between gallbladder and duedenum or jejunum was performed on group C and group D. The animals' postoperative performance status were evaluated. Cholangiography was used to define the patency of bile ducts. Tissues of bile ducts and liver were taken at 3 days, 2, 4, 8, 12 and 52 weeks for microscopic and ultrastructural examination to observe the healing process of bile duct and morphological changes in the liver. Results Group A with ePTFE patch covered by epithelium had a high patency rate of 75%(9/12) and pathological damages were not found in the liver. The patency rate of group B was merely 40%(4/10), to some extent, accompanying damages in the liver. The grafts of group C and group D were fully expelled, ultimately leading to cystic duodenal or cystic jejunal fistulas formation. Conclusion The study suggests that application of ePTFE patch to repair bile duct defects is feasible.

关 键 词：膨体聚四氟乙烯 修复 胆管缺损 实验研究 

分 类 号：R657.4[医药卫生—外科学]