大网膜人工窦道预防胆管引流管拔出后胆漏的动物实验研究

Animal experiment study of man-made sinus with greater omentum to prevent bile fistula after removal of biliary drainage tube

目的探讨采用带蒂大网膜在胆管引流管周围做成人工窦道的方法及效果。方法建立实验兔胆管引流动物模型。100只新西兰大白兔随机分为2组,即实验组及对照组。每组再随机分成5个亚组,每亚组10只,在手术后3、6、9、12、15d分别剖腹了解5亚组中一亚组胆管引流管窦道形成情况,并取部分窦道壁送病理检查。结果实验组在不同时间点,窦道完全形成动物数分别为:3d8只,6d10只,9d10只,12d10只,15d10只;对照组分别为:3d1只,6d1只,9d2只,12d3只,15d4只。两组比较差异有统计学意义(P<0.01)。结论采用带蒂大网膜在胆管引流管周围形成人工窦道的方法简单、实用,不仅可缩短留置T管的时间,而且可有效防止拔T管后胆漏的发生,值得临床推广使用。

Objective To investigate the methods and effects of man-made sinus around the biliary drainage tube using pedicled greater omentum. Methods The rabbit models were established by means of man-made sinus around the biliary drainage tube using pedicled greater omentum. One hundred New Zealand white rabbits were randomly divided into 2 groups： experiment group and control group, and each group was randomly divided into 5 sub-groups, each having 10 rabbits. The formation of sinus around biliary drainage tube was examined on the 3rd,6th,9th, 12th, 15th day after operation respectively, and the sinus wall tissue was pathologically examined. Results The animal number of complete formation of sinus in the experiment group at different time points was：8 on the 3rd day, 10 on the 6th day, 10 on the 9th day, 12 on the 12th day, 10 on the 15 th day respectively, and that in the control group was： 1 on the 3rd day, 1 on the 6th day,2 on the 9th day,3 on the 12th day,4 on the 15th day re- spectively. The difference was significant （P〈0.01）. Conclusion The man-made sinus, as shown by results,shortening the time for the indwelling T-tube and reducing such postoperative complication rate as bile fistula after removal of T-tube,is worthy of popularization for clinical use.