| Purpose:because im bravery is the biliary surgery with the most commonly used surgical biliary reconstruction, and major postoperative Roux-en-Y anastomosis and major postoperative loops with two of the type is recognized by a good method, but they both long-term effect between the comparison, for many years has not concluded that consistency conclusion. This experiment through than case shall only20dogs, into two groups, namely the gallbladder jejunum Roux-en-Y anastomosis and gallbladder jejunum loops type with two different operation, and observation to compare two different operative methods than the case of dog, gallbladder jejunum anastomotic the healing process ultrastructure and its influencing factors, clinical guidance, which can effectively prevent stenosis surgery and tumor formation.Methods:the dog than case only20, the only10, we adopt the gallbladder jejunum Roux-en-Y anastomosis and gallbladder jejunum loops type with two different operation, respectively for under light microscopy in the next two group HE dyed the microscopic structure of the characteristics; By immunohistochemical method to detect TGF β1and b-FGF in the expression of strength, gallbladder scar positive cell count, and organization distribution.Result:Compared to surgery time:Roux-en-Y anastomosis than the loop-type anastomosis, operation time was significantly prolonged; Roux-en-Y anastomosis and loop anastomosis anastomotic diameter, B> A and B1> A1, B1> A2, B2> A2, traditional Chinese medicineand control groups compared to A1> A2, B1> B2, and B1> A2; the percentage of collagen fibers after HE staining, two different surgical comparison, A> Band A1> B1,A2> B2, and A2> B1;TGF-β1and b-FGF in different biliary-enteric anastomosis,6months, in the anastomotic scar tissue expression:A> B, A1> B1, A2> B1, A2> B2; traditional Chinese medicine group and control group were immunegroup of observation:b-of FGF, TGF-β1in the number of positive cells the expression of traditional Chinese medicine group "control group", A2> A1, B1<B2, B1<A2. Conclusion:bile duct in morphology of scar tissue with chronic inflammation persist, fibroblasts and small vascular proliferation active and collagen fiber and the character ristics of sedimentary there too. MΦlong-term in bile duct in the wall is a cause of calm the BBS a factor. MΦthrough the paracrine way secrete TGF β1, promote the transformation and the collagen fiber MFB excessive deposits. MFB is a cause of the main factors of bile duct scar contracture. The role of bile, using reflux and bile duct injury repair the silk suture foreign body reaction may be caused to the local organization M Φ bile duct excessive calm of the important factors that adding bile duct scarring. Benign bile duct in the scar tissue bFGF over-active, both were positively correlated. BFGF may be in benign bile duct scar the formation mechanism of the plays an important role. |
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