小肠黏膜下基质用于胆管重建的研究

目的 探讨在肝外胆管节段性缺失时,小肠黏膜下基质(SIS)用于重建胆管的可行性及相关机制,为胆道重建寻找新的思路.方法 SIS制成管状,实验犬6条,胆总管节段性切除12～15 mm,以SIS管桥接.分别于术后3、9周取材,通过胆道造影、病理等方法观察胆道重建过程和组织重构效果.结果存活率100％,胆瘘、胆道闭塞发生率为0.胆管收缩、狭窄现象普遍,长度收缩约(13.5±4.1)％.病理检查见胆管内膜细胞覆盖植入SIS段胆管,管壁由成纤维细胞构成,新生血管丰富.结论 SIS材料制成管状用于替代胆管节段性缺失是可行的,可以避免胆漏,无管腔塌陷、闭塞.

Heterogeneous small intestinal submucosa as a scaffold for bile duct tissue for regeneration and reconstruct in canine models

Objective The purpose of this study is to evaluate the feasibility of using heterogeneous small intestinal submucosa (SIS) as a scaffold for bile duct tissue to regenerate and reconstruct on in a canine model,and to find a new method for bile duct recostruction to replace cholangiojejunostomy.Methods Six,mongrel dogs underwent a resection of the common bile duct with 12-15 mm in length.All the dogs then had a tube placed interpositionally in situ for connecting the two ends of the ducts,the tube was made of 4-ply SIS and was 20 mm in length.Three dogs were sacrificed 3 weeks later and the other three dogs were sacrificed 9 weeks later postoperatively,after the cholangiogram on each dog.The bile duct was examined histologically.Results All the dogs survived and went on well at the time of sacrificing.The SIS graft was found to be infiltrated with native fibroblasts,blood vessels within 3 weeks.The SIS graft was replaced with native collagen covered with a biliary epithelium and biliary mucosa within 9 weeks.The grafted bile duct contracted and (13.5 ±4.1 )％ length was reduced as a result.All the dogs in this study developed a stricture at the proximal anastomosis within 3 weeks,and the common bile duct was dilated.Conclusion SIS can be used as a scaffold for regeneration and reconstruction for bile duct tissue in a canine model.