Management of Electrothermal Injury of Common Bile Duct with a Degradable Biliary Stent: an Experimental Study in a Porcine Model
Management of Electrothermal Injury of Common Bile Duct with a Degradable Biliary Stent: an Experimental Study in a Porcine Model
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可降解胆道支架治疗胆总管电热损伤：猪模型的实验研究
DOI：
10.1007/s11605-013-2316-0
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发表时间：
2013-10-01
影响因子：
3.2
通讯作者：
Cai, XiuJun
中科院分区：
文献类型：
--
作者：
Wang, YiFan;Liang, YueLong;Cai, XiuJun
胆总管电热损伤是常见的胆道损伤类型。术后病程长、拔除T管后胆漏与外引流有关。将实验猪分为支架修复组（SR组，n = 18）、T管修复组（TR组，n = 4）和胆道支架修复组（SUR组，n = 4）。采用电凝法制备大鼠颅脑损伤模型。根据观察时间（2周和1、3、6和18个月）将SR组猪进一步分为5个亚组。TR组和SUR组观察6个月。重复胆管造影并监测胆红素水平。观察结束后再次手术，SR组无胆管狭窄、胆漏及胆管坏死发生。支架可在前2个月内检测到。未观察到支架移位或支架相关阻塞。SUR组有3只猪出现胆管狭窄伴胆红素升高，提示该方法修复胆总管损伤是安全可行的。
Electrothermal injury of common bile duct is a frequent type of biliary injury. A long-term postoperative course and biliary leakage after removing T-tube are associated with external drainage. A method was developed to repair the injury with a degradable biliary stent instead of T-tube insertion.Pigs were divided into a stent repair (SR) group (n = 18), a T-tube repair (TR) group (n = 4), and a suturing repair (SUR) group (n = 4). An electrothermal injury model was made by electric coagulation. Pigs in the SR group were further divided into five subgroups according to the observation time (2 weeks and 1, 3, 6, and 18 months). Pigs in the TR group and SUR group were observed for 6 months. Cholangiography was repeated and bilirubin level was monitored. Pigs were reoperated for further evaluation at the end of observation.No biliary stricture, bile leakage, or bile duct necrosis occurred in the SR group. The stent could be detected in the first 2 months. No stent migration or stent-related obstruction was observed. Three pigs in the SUR group had biliary stricture with elevated bilirubin levels.These results suggested that the developed method for repairing electrothermal injury of common bile duct is feasible and safe.