液氮冷冻胰腺时保护毗邻器官的方法——十二指肠内灌流温热生理盐水(动物实验)

Method of Protecting Adjacent Organs During Freezing of Pancreas with Liquid Nitrogen——Warm Saline Perfusion of Duodenum

胰腺为一隐蔽器官,尤其胰头毗邻器官较复杂。长期以来,人们对冷冻法治疗胰头癌有损伤其毗邻器官之虞。本实验用大耳家兔在冷冻胰头时采取十二指肠内灌注温热生理盐水,消耗液氮对胰腺以外毗邻器官的制冷效能。实验结果表明,动物生态4～5天恢复正常,血胰淀粉酶测定4～7天下降至正常水平。术后1～30天剖检冷冻区坏死,继之机化为纤维组织,周围器官有纤维素性粘连,无坏死、穿孔、狭窄现象。光镜检查,胰腺冷冻区为界限清楚的退变坏死区;非冷冻区胰腺无急性弥漫性胰腺炎征象。与胰腺相毗邻的十二指肠壁无坏死穿孔及损伤性炎症反应。本实验初步证明临床应用的可行性。

Recent reports of general treatment trials of cancer of pancreas head by hypo-thermic refrigeration were available but with the worry about damages adjacentorgans during freezing of pancreas.In this study eight adult bigger rabbits(No.1-8),were used.A silastic catheter was inserted through the anterior wall of the pyloricantrum,passing through the pylorus and duodenum,and was let out at the proximaljejunum.Four holes were pre-cut in the 3cm segment of the catheter located at thelumen of duodenum for in and out-flow of water.Warm saline was perfused intoand drained out of the lumen of duodenum during freezing of pancreas by liquidnitrogen.Results:The general oondition was improved with recovery on the 4th day,pre-operative level of serum amylase was resumed within 4-5 days.Eight animalssustained direct observation by dissection 1、4、5、10、15、20、25 and 30 post-operativedays respectively.On the 5th-10th days post-operatively,a white nodule was seenin the freezed area,with a clear cut line distinguished from the surrounding tissue.There were fibrous adhesions between surrounding organs.Histopathology:A clear-cut area of degenerative necrosis was seen at the refrigerated area of pancreatic-tissue,no signs of widespread acute pancreatitis were seen in the non-refrigeratedarea.It was indicated that this technique was practicable in clinical applications.