胰胆管合流异常对胰腺损伤的实验研究

目的 探讨胰胆管合流异常(APBDU)对胰腺的损伤.方法 选择健康杂种猫10只,在胆管、胰管近十二指肠处纵行切开4～6 cm,然后间断吻合,以建立胰胆管合流异常的模型.手术造模时及术后6个月分别取胰腺组织行病理检查、电镜观察及胰腺组织丙二醛(MDA)水平检测.结果 7只猫生存6个月.术后6个月胰腺呈暗红色,充血、水肿,其中3只猫胰腺表面可见扩张的胰管.光镜下见3只猫胰腺有炎性细胞浸润,4只猫胰腺有间质血管增生、白细胞附壁.电镜下见胰腺腺泡细胞粗面内质网扩张,有的呈池状;线粒体数量增多、体积增大、崩解;高尔基复合体发达.手术前胰腺组织MDA水平为(1.23±0.7)nmol/mg prot,术后6个月升高达(2.90±1.9)nmol/mg prot,相差显著(F=4.80,P=0.0215).结论 胰胆管合流异常可导致胰腺损伤,抗氧化可能有助于减轻该损伤.

Effect of anomalous pancreaticobiliary ductal union on the injuries of pancreas

Objective To investigate the effect of anomalous pancreaticobiliary ductal union on the injuries of pancreas.Methods 10 health cats were treated by a 4～6 cm incision in biliary and pancreatic duct adjacent to duodenum, and interrupted suture was made to induce the model of anomalous pancreaticobiliary ductal union.The pancreatic tissues were harvested during model induction and 6 months after model induction,and histopathological changes were evaluated by electron microscopic examination and the level of maleic dialdehyde (MDA) were determined.Results Seven out of 10 cats survived surgery and remained alive for 6 months.6 months later,the pancreas appeared to be in the color of dark red and hyperemia,edema was present.Dilated pancreatic duct could be found in three of them.Light microscopic examination suggested there was inflammatory cell infiltration in the pancreas in 3 cats;mesenchymal vascular proliferation and white cell adhesion was present in the pancreas in 4 cats.Electron microscopic examination suggested rough endoplasmic reticulum expanding in the shape of pool,swelling mitochondria disaggregated and increased in number,Golgi complex became well developed.The preoperative level of MDA in pancreatic tissue was (1.23±0.7 ) nmol/mg prot,which increased to (2.90±1.9 ) nmol/mg prot 6 months later with statistically significant difference (F=4.80,P=0.0215 ).Conclusions This animal model demonstrated that anomalous pancreaticobiliary ductal union may cause injury to the pancreas,and antioxidant treatment may alleviate this injury.