可吸收缝线缝扎兔胆总管致良性狭窄模型的建立

Development of a rabbit model for benign stricture by partial common bile duct ligation with absorbable surgical suture

目的利用可吸收缝线缝扎部分胆总管建立兔损伤性胆管狭窄动物模型。方法 24只新西兰兔按完全随机方法分为3组:正常对照组、假手术对照组和手术组。手术组用6-0可吸收缝线缝扎1/2胆总管,手术当天和术后15、30 d检验血清肝功能指标,取狭窄段胆总管行HE染色、Masson三色染色检测胶原纤维和肌纤维的表达,免疫组化DAB法检测狭窄段胆管组织Ⅰ、Ⅲ型胶原的表达。结果手术组动物直接胆红素、间接胆红素、丙氨酸氨基转移酶和天门冬氨酸氨基转移酶在30 d均高于术前(P<0.01)。术中观察胆总管损伤处明显狭窄,手术组病理切片中,胶原纤维大量增生形成瘢痕组织,Ⅰ、Ⅲ型胶原随着时间推移表达强度逐渐增强。结论可吸收缝线缝扎法可有效建立兔胆总管良性狭窄模型。

Objective To establish a rabbit model for benign stricture by partial ligating common bile duct through absorbable surgical suture. Methods Twenty-four New Zealand rabbits were randomly divided into 3 groups： normal control group, sham-operation group and surgery group. The benign stricture of the common bile duct was achieved in the rabbits by partial ligation （50%） with VICRYL Rapide suture 6-0. Levels of liver function indicators were measured in 15 and 30 d after surgery. After a stricture was identified, the animal was killed and common bile duct samples were obtained for histopathological evaluation. The expression of collagen type Ⅰ and collagen type Ⅲ was measured by immunohistochemical assay. Results Serum levels of direct bilirubin （DBIL）, indirect bilirubin （IDBIL）, alanine aminotransferase （ALT） and aspartate aminotransferase （AST） were significantly higher than before surgery in the surgery group （P 〈0. 01 ）. The lesion of common bile duct was significantly stricture. Hematoxylin-eosin staining revealed that excess collagen deposition and formation of scar tissue were observed in the surgery group than the control group. The expression of collagen type Ⅰ and Ⅲ in the stricture bile ducts was enhanced with the time elapse in the surgery group. Conclusion Partial ligation of the common bile duct with the absorbable surgical suture is effect in the establishment of an animal model of benign common bile duct stricture.