科研之友
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摘要
Bile duct injury (BDI) is one of the most severe complications of biliary operation. This study is to investigate the correlation between the timing of bile duct repair and anastomotic bile duct stricture. Transverse BDI models were constructed in 60 dogs that were divided randomly into BDI5, BDI10, BDI15, BDI20, and BDI30 groups according to days of injury (5, 10, 15, 20, and 30 days). The morphological and histological changes of anastomotic stoma of hepaticojejunostomy (HJ) were observed after bile duct reconstruction. TGF-beta 1, alpha-SMA, and collagen of anastomotic stoma were detected. After HJ, the concentration of direct bilirubin decreased significantly, dropping to 50% after one week, and returning to normal levels after three weeks. The anastomotic diameter shrunk from 1.5 cm to 0.6 cm without significant difference. At 3 months and 6 months after HJ, the expression of TGF-beta in the anastomotic tissue in BDI5 group was higher than that in BDI10, BDI15, BDI20, and BDI30 groups. However, no significant differences were observed (F = 1.282, P > 0.05 at 3 months; F = 1.308, P > 0.05 at 6 months). Similarly, the expression of alpha-SMA and collagen did not vary significantly. For obstructive BDI, repairing time is not a relevant factor for postoperative anastomotic stenosis, but surgeons and operation methods are the key factors. For patients with BDI, hospitals should focus on the experience of surgeons and the choice of operation methods in order to achieve a good long-term effect.
