生物粘合剂预防胆道狭窄的实验观察

Use of fibrin glue in choledochojejunostomy for prevention of stricture

目的：明确生物粘合剂（ＦＧ）取代缝线重建胆道，能否预防吻合口狭窄。方法：将５４只杂种犬随机分为Ａ、Ｂ、Ｃ三组。Ａ组ＲｏｕｘｅｎＹ胆总管空肠ＦＧ粘合组；Ｂ组ＲｏｕｘｅｎＹ胆总管空肠ＦＧ粘合加内支撑导管组；Ｃ组ＲｏｕｘｅｎＹ胆总管空肠粘合加内支撑定期拔除组。于术后３周、３月、６月、９月、１２月取Ａ组、Ｂ组吻合口瘢痕组织，Ｃ组同期拔出内支撑导管，再过２个月后取吻合口瘢痕组织，用生化方法测量其中胶原含量（ＢＣＣ）。结果：Ａ组术后９个月瘢痕组织中ＢＣＣ差异无显著性（Ｐ＞０．０５），Ｂ组、Ｃ组术后６个月瘢痕组织中ＢＣＣ差异无显著性（Ｐ＞０．０５）。结论：ＦＧ可促进胆道伤口愈合，加速瘢痕成熟、软化，为预防胆道狭窄提供有效措施。

Objective:To determine the result of using fibrin glue(FG) instead of conventional suture in experimental bile duct reconstruction for preventing anastomotic stricture.Methods:54 dogs were divided at random into 3 groups.Group A( n =18),choledochojejunostomy was made with FG for anastomosis;in group B( n =18),choledochojejunostomy with FG for anastomosis,together with an indwelling stent;in group C( n =18),the indwelling stent was removed after a definite time.The anastomotic scar tissues were taken for examination of biochemical collogen content(BCC) at 3 weeks,3 months,6 months,9 months and 12 months after operation.Results:BCC in group A showed no significant difference 9 months after operation.BCC in group B and group C showed no significant difference 6 months after operation.Conclusions:FG has the advantages in promoting wound healing,limiting scar formation and accelerating scar maturation.Together with indwelling stent is an effective measure in preventing anastomosis stenosis.