皮下通道型胆囊肝胆管成形术后胆汁成分分析

目的 研究皮下通道型胆囊肝胆管成形术(STHG)后胆汁成分的变化及意义。方法26例择期手术的肝胆管结石患者分为皮下盲襻型肝胆管空肠吻合术组(SLCJ组)14例,STGH组12例,术中及术后第4周分别引流肝门部胆汁,各份胆汁行细菌培养、胆汁脂质成分定量分析以及黏蛋白、过氧化物歧化酶和过氧化脂质测定。结果 术后28d,STHG组和SLCJ组细菌培养阳性率分别为25％和86％;与SLCJ组相比,STHG组肝门部胆汁中总胆汁酸浓度明显升高,而Ca~(2 )和游离胆红素的浓度积差异无显著性,黏蛋白和过氧化脂质明显降低,而过氧化物歧化酶显著升高。结论 与SLCJ相比,STHG后胆汁成分的变化更有利于防止色素结石的复发。

The analysis of the bile component following subcutaneous tunnel and hepatocholangioplasty with the use of gallbladder

Objective To study the changes of the bile component following subcutaneous tunnel and hepatocholangioplasty with the use of gallbladder (STHG). Methods twenty-six patients with hepatolithiasis were divided into two groups: SLCJ group ( n = 14) and STGH group ( n = 12). To observe the changes of the bile components, such as Ca~(2 ), unconjugated bilirubin (UCB), mucin, superoxide dismutase (SOD) and lateral preoptic (LPO), the bile of each patients was drained during the operation, 4 weeks postoperatively. Results There was no signficant difference in bile components drained during the operation. In SLCJ group and STHG group, positive rate of germiculture was 86% and 25% respectively on 4 weeks postoperatively. The concentration of bile acid of patient' s bile at hepatic porta in STHG group was higher than that in SLCJ group, while the multiplication of the concentration of Ca~(2 ) and UCB had no significant difference between the 2 groups. The concentration of mucin and LPO of patient' s bile at hepatic porta in STHG group was lower than that in SLCJ group, while SOD of patient's bile at hepatic porta in STHG group was higher than that in SLCJ group. Conclusion The changes of bile components of patients following STGH have the advantages of preventing pigment stone.