With the developments of surgical skills and immunology, bile duct complications after liver transplantation have been reduced from half to less than one third, but the incidence of bile duct stenosis after transplant...With the developments of surgical skills and immunology, bile duct complications after liver transplantation have been reduced from half to less than one third, but the incidence of bile duct stenosis after transplantation is still as high as 17%.^1,2 During liver transplantation, bile ducts may be damaged in several ways, most of which affect directly or indirectly peribiliary vascular plexus (PVP) and lead to bile duct complications after operation. The complications are more common in hepatohilar bile ducts because of lack of collateral circulation and easily damaged blood supply^3,4 so that it is necessary to know the anatomical structure of PVP. This study explored the anatomical structure of hepatohilar PVP in rats and dogs using the three dimensional reconstruction technique of computer microvisualization with MoticBuaa3Dvol software and ink perfusion, transparency management.展开更多
AIM: To explore the influence of portal vein hemodynamic changes after portal venous arterialization (PVA) on peribiliary vascular plexus (PVP) morphological structure and hepatic pathology, and to establish a th...AIM: To explore the influence of portal vein hemodynamic changes after portal venous arterialization (PVA) on peribiliary vascular plexus (PVP) morphological structure and hepatic pathology, and to establish a theoretical basis for the clinical application of PVA. METHODS: Sprague-Dawley rats were randomly divided into control and PVA groups. After PVA, hemodynamic changes of the portal vein and morphological structure of hepatohilar PVP were observed using Doppler ultrasound, liver function tests, ink perfusion transparency management and three-dimensional reconstruction of computer microvisualization, and pathological examination was performed on tissue from the bile duct wall and the liver. RESULTS: After PVA, the cross-sectional area and blood flow of the portal vein were increased, and the increase became more significant over time, in a certain range. If the measure to limit the flow in PVA was not adopted, the high blood flow would lead to dilatation of intrahepatic portal vein and its branches, increase in collagen and fiber degeneration in tunica intima. Except glutamic pyruvic transaminase (GPT), other liver function tests were normal. CONCLUSION: Blood with a certain flow and oxygen content is important for filling the PVP and meeting the oxygen requirement of the bile duct wall. After PVA, It is the anatomic basis to maintain normal morphology of hepatohilar bile duct wall that the blood with high oxygen content and high flow in arterialized portal vein may fill PVP by collateral vessel reflux. A adequate measure to limit blood flow is necessary in PVA.展开更多
文摘With the developments of surgical skills and immunology, bile duct complications after liver transplantation have been reduced from half to less than one third, but the incidence of bile duct stenosis after transplantation is still as high as 17%.^1,2 During liver transplantation, bile ducts may be damaged in several ways, most of which affect directly or indirectly peribiliary vascular plexus (PVP) and lead to bile duct complications after operation. The complications are more common in hepatohilar bile ducts because of lack of collateral circulation and easily damaged blood supply^3,4 so that it is necessary to know the anatomical structure of PVP. This study explored the anatomical structure of hepatohilar PVP in rats and dogs using the three dimensional reconstruction technique of computer microvisualization with MoticBuaa3Dvol software and ink perfusion, transparency management.
基金Supported by Science and Technology Plan of Xiamen City,No.3502Z20064005Health Bureau of Xiamen City,No.WSk0521
文摘AIM: To explore the influence of portal vein hemodynamic changes after portal venous arterialization (PVA) on peribiliary vascular plexus (PVP) morphological structure and hepatic pathology, and to establish a theoretical basis for the clinical application of PVA. METHODS: Sprague-Dawley rats were randomly divided into control and PVA groups. After PVA, hemodynamic changes of the portal vein and morphological structure of hepatohilar PVP were observed using Doppler ultrasound, liver function tests, ink perfusion transparency management and three-dimensional reconstruction of computer microvisualization, and pathological examination was performed on tissue from the bile duct wall and the liver. RESULTS: After PVA, the cross-sectional area and blood flow of the portal vein were increased, and the increase became more significant over time, in a certain range. If the measure to limit the flow in PVA was not adopted, the high blood flow would lead to dilatation of intrahepatic portal vein and its branches, increase in collagen and fiber degeneration in tunica intima. Except glutamic pyruvic transaminase (GPT), other liver function tests were normal. CONCLUSION: Blood with a certain flow and oxygen content is important for filling the PVP and meeting the oxygen requirement of the bile duct wall. After PVA, It is the anatomic basis to maintain normal morphology of hepatohilar bile duct wall that the blood with high oxygen content and high flow in arterialized portal vein may fill PVP by collateral vessel reflux. A adequate measure to limit blood flow is necessary in PVA.