壁腹膜和空肠粘膜瓣修复胆管缺损后的光镜和扫描电镜观察

The Light Microscope and Scanning Electron Microscope Observation After Common Bile Duct Repair with Parietal Peritoneum and Jejunum Mucosal Flap

目的 :为了筛选理想的胆管缺损修复材料 ,对壁腹膜和空肠粘膜瓣作对比研究。方法 :实验犬 10只 ,随机分两组 ,分别用壁腹膜加带蒂大网膜覆盖和空肠粘膜瓣进行胆总管缺损修复手术。术后作光镜和扫描电镜观察。结果 :壁腹膜组术后 5周起 ,在移植物的表面即有胆管上皮形成 ,扫描电镜下可见密集的胆管上皮微绒毛。空肠粘膜瓣修复胆管后 ,肠绒毛逐渐变少和消失 ,未见新生胆管上皮细胞形成。结论

Objective:This article was engaged in finding an suitable material for the repair of bile duct. Methods: Ten experimental dogs were divided into two groups. The common bile duct defects were repaired by parietal peritoneum covered with vascularized greater omentum or jejunum mucosal flap respectively. These grafts were examined under both light microscope and scanning electron microscope (SEM) after operation. Results: Five dogs were used in parietal peritoneum group. Microscopic examination showed that the biliary epithelium had migrated over the surface of the parietal peritoneum from the 5th week after operation. SEM examination showed that the microvillous structures of biliary epithelium were densely formed on the surface of grafts, some arteries and veins had penetrated the parietal peritoneum grafts, and there were no evidences of the ischemic necrosis. Five dogs were used in jejunum mucosal group. SEM examination showed that the apex of jejunal villus faded by 5th weeks after operation, jejunal villus merged by 10th week, a part of jejunal villus disappeared and another part over lapped each other by the 20th week. Conclusion: The parietal peritoneum covered with vascularized greater omentum is one of the selected materails for repairing the bile duct defect.