兔胆管形伤后一期修补缝线粗细的选择

Selection of Sutures Used in Primary Repair of Common Bile Duct Injury in Rabbits

本实验以家兔为实验对象，建立胆管损伤模型，１２只兔分为４组，一组作为对照，胆总管只游离，另外三组胆总管纵形伤后分别以６／０、７／０及９／０无损伤锦纶缝线按显微外科技术进行修补，术后不置管。２周后６／０缝线组肝脏有广泛的肝细胞变性，胆管明显扩张（ｐ＜０．０１）；７／０缝线组小片状肝细胞变性，胆管扩张不明显（ｐ＞０．０５）；９／０组与对照组相比，肝脏无明显改变，胆管扩张无显著性差异（ｐ＞０．０５）。认为对术中发现的直径２～３ｍｍ肝胆管线形伤可选择７／０或９／０无损伤缝线（绵纶）按显微外科技术一次修补，如无胆道梗阻因素（如结石、狭窄等），则术后可不另置管支撑引流。

Animal model of bile duct injury was set up by using scalpel to make a longitudinal incision in common bile duct of rabbits.Twelve rabbits were divided into four groups.In group one as a control group,the common bile duct was dissected only.In group two ,after injuring the common bile duct,the incision was repaired immediately by using 6/0 polyamide fibre MASN(medical atrauratic suture needle)with microsurgical technique,while in group three and four by using 7/0 and 9/0 sutures,respectively.Two weeks later,laparotomy was performed in all animal.Compared with the control group,the common bile ducts were distended significantly(p<0 01)and the hepatic cells were widely degenerated in group two,while there were no significant changes in groups three and four(p>0 05). In conclusion,this study indicated that 7/0 or 9/0 MASN were better sutures of choice to repair the thread like injuries of the common bile duct having 3mm diameter with microsurgical technique without T tube stent if there were no obstructive factors in the biliary tree.