犬胆肠吻合愈合过程的组织学观察

An histological observation of healing process after bilioenteric an astomosis in the dog

目的 观察胆肠吻合愈合过程的组织学变化，探讨良性胆管狭窄形成机制。方法 通过制作犬胆总管十二指肠吻合模型，分别于术后3d、1周、3周、3月、6月取材行HE染色、Masson染色及Verhoeff's染色，并进行计算机图像分析测定粘膜下胶原纤维面积百分比。结果 胆肠吻合愈合过程延长，慢性炎症持续存在，胆道粘膜上皮修复较差，成纤维细胞增生活跃，愈合后粘膜下胶原纤维过度沉积，改建较差。结果导致瘢痕增生，吻合口狭窄。结论 胆肠吻合愈合方式属于过度愈合，其原因与胆管壁组织构筑、胆汁刺激作用及肠胆返流有关。

Objective To observe histological changes of healing process after bilioenteric anastomosis and discuss the mechanism of benign bili ary stricture. Methods A model of choledochoduodenostomy in the dog was constructed at first, then HE, Masson and Verhoeff's staining were used r espectively for anastomosis tissue in 3d, 1,3week and 3,6month after operation. The percentage of submucosal collagen fiber area was determined at the same time .Results The epithelium of mucosa membrane of bile duct restore d badly, chronic inflammation was lasting for a long time, fibroblasts proliferat ed actively, submucosal collagen fiber overdeposited after healing and rebuilded badly. The results leaded to scar proliferation and anastomotic stenosis.Conclusion The mode of healing belonged to overhealing. The cause s le ading to overhealing were related to the histologic feature of bile duct, the st imulating effect of bile and entericbiliary reflux.