自体腹膜重建门静脉的研究

Study on the reconstruction of the portal vein with autogenous peritoneum.

目的探讨采用自体腹膜重建门静脉的可行性。方法采用健康幼猪27头,切除一段门静脉,分别以自体腹膜管、自体静脉和涤纶人工血管重建门静脉,观察重建后腹膜管通畅情况及组织病理变化。结果腹膜重建门脉后1个月通畅率92.3%(12/13);3个月时通畅率为80.0%(8/10),5个月后通畅率为66.7%(4/6);较采用自体静脉稍低;采用人工血管重建者均在术后3～5小时内发生门脉栓塞死亡。3个月时电镜显示腹膜管腔面为内皮样细胞覆盖,含内皮细胞和间皮细胞二种成分。结论采用自体腹膜重建门脉有较高的通畅率,腹膜是一种很有前途的自体门脉重建材料,值得进一步研究。

Objective To study the possibility of portal vein reconstruction using autogeneous peritoneum. Methods Twenty-seven small healthy domestic pigs were used in the study. About 2.5-3.0 cm long of portal vein was resected and reconstructed by autogenous peritoneum, autogenous vein and decron artificial blood vessel respectively. Patency and pathological changes of the grafts were investigated after the reconstruction. Results At the first month, 3rd month and 5th month after the reconstruction with peritoneum the canal patency rate (CPR) of portal vein was 92.3% (12/13), 80% (8/10), and 66.7% (4/6) respectively, which was quite similar to that reconstructed by autogeneous vein. The pigs reconstructed by decron vessel were all dead within 3 to 5 h after operation because of portal thrombi found by autopsy. After 3 months of reconstruction, scanning electron microscopy revealed that the peritoneal grafts were covered with a layer of endothelial-like cells. Both endothelial cells and mesothelial cells were observed under transmitted electronic microscopy. Conclusion Portal vein reconstruction using autogenous peritoneum revealed a high patency. Peritoneum might be a perspective self-material for portal vein reconstruction and worth further studying.