Development a New Biliary Reconstruction Using Antireflux Intestinal Spur Valve

本研究旨在建立一种最佳的肠道抗返流支流瓣膜的构建方法，以预防肝门肠吻合术及类似条件下发生上行性胆管炎。材料和方法：杂种犬14只，体质量10~20 kg，雌雄不拘，其中2只作为对照。所有犬均剥离空肠管远端一侧的浆肌层，然后将剥离区的边界缝合到十二指肠。6只犬瓣膜大小为2 cm，6只犬瓣膜大小为5 cm，其余2只对照犬未做瓣膜置入。结果：结果：评价结果为差、可、好。对照组犬无瓣膜动作，易观察到反流现象。在瓣膜大小为2 cm的犬中，6只狗中4只效果良好，2只可。而瓣膜大小为5 cm的犬，6只中3只良好，2只较差，1只可。一般和良好病例的开启压力范围为11~20cmH20。在后期的检查中，瓣膜的抗反流机制的效果优于早期的检查，这是由于瓣膜内最初的轻度炎症过程所致。

We conducted this study to establish the best method for construction of intestinal antireflux spur valve which could be beneficial in prevention of ascending cholangitis in cases treated by hepatic portoenterostomy and similar conditions.Materials and Methods :Fourteen Mongrel dogs of both sexes weighing from 10-20Kg were used, among which 2 dogs served as control. For all dogs, a spur valve was constructed by denuding the seromuscular layer of one side of the distal end of the jejunal conduit and then suturing the boundries of the denuded area to the duodenum. The size of the valves was 2cm in 6 dogs, 5cm in 6 dogs and no valve was constructed in the remaining 2 control dogs. Manometric studies, barium studies and histopathological studies were performed.Results :Results were expressed as poor, fair and good. In control dogs there was no valve action and reflux could be observed easily. In dogs with 2cm sized valve 4 out of 6 showed good results and 2 fair. While in dogs with 5cm sized valve 3 out of 6 were good, 2 poor and 1 fair. Opening pressure in fair and good cases ranged from 11 to 20 cmH20. The efficacy of the valve for anti-reflux mechanism was better in later examinations than in earlier ones and it was due to the initial mild inflammatory process within the valve.