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膨体聚四氟乙烯补片修复胆管缺损的实验研究
引用本文:任为,时德.膨体聚四氟乙烯补片修复胆管缺损的实验研究[J].中国修复重建外科杂志,2001,15(5):305-307.
作者姓名:任为  时德
作者单位:重庆医科大学附属第一医院普外科
基金项目:重庆市科委中青年科技专家基金(99-44-38)
摘    要:目的 探讨膨体聚四氟乙烯(ePTFE)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ePTFE补片修补胆管缺损,管形材料替代胆管,间置材料在胆囊、十二脂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通畅情况,并在术后3天,2、4、8、12及52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ePTFE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 ePTFE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。

关 键 词:膨体聚四氟乙烯  修复  胆管缺损  实验研究
修稿时间:2000年7月14日

EXPERIMENTAL STUDY ON REPAIR OF BILE DUCT DEFECTS WITH EXPANDED POLYTETRAFLUOROETHYLENE
REN Wei,SHI De.EXPERIMENTAL STUDY ON REPAIR OF BILE DUCT DEFECTS WITH EXPANDED POLYTETRAFLUOROETHYLENE[J].Chinese Journal of Reparative and Reconstructive Surgery,2001,15(5):305-307.
Authors:REN Wei  SHI De
Institution:Department of General Surgery, First Affiliated Hospital, Chongqing Medical University, Chongqing, P. R. China 400016.
Abstract: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.
Keywords:Expanded polytetrafluoroethylene    Bile duct    Repair
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