Post-operative Of The Choledochojejunostomy Comparative Study Of Biliary Tract Bacterial Changes And The Chinese Medicine Intervention Effect

Objective:Surgical model of beagle dogsexperimentally, A group caused by Group Roux-en-eholedoehojejunostomy, another group is Application of Jejunum Ligation in Input Loop choledochojejunostomy model. Placing in the biliary drainage tube in vitro, bying Bacterial culture of bile, Identify changes the similarities and differences between the two groups. Exploring Chinese medicine Dachaihu decoction in Post-Choledochojejunostomy to control the value of the biliary tract infections.Methods:1. twenty experiments number beagle dogs were randomly divided into Roux-en-eholedoehojejunostomy group(A group) and Application of Jejunum Ligation in Input Loop choledochojejunostomy group(B group). A group caused by Group Roux-en-eholedoehojejunostomy, another group is Application of Jejunum Ligation in Input Loop choledochojejunostomy model. Were compared to surgical length of time, to observe the two groups after7days of blood and liver function index changes,and to assess the severity of the postoperative biliary tract infection symptoms.2. seven days late, Group A set of random number is divided into irrigation traditional Chinese medicine group (group A1) and control group (group A2); Group B set of random number is divided into irrigation traditional Chinese medicine group (group B1) and control group (group B2), Chinese medicine regularly to gived Chinese medicine Dachaihutang gavage. Regular basis7days late Postoperative were collected4teams bile and bacterial culture.Comparison4groups biliary bacteriology changes.3. six months after surgery, the experimental animals were sacrificed and autopsy,measurement of biliary-enteric anastomotic diameter, and compare its size with or without a difference.Results:1. Roux-en-eholedoehojejunostomy group of surgical time average longer than in group fo Application of Jejunum Ligation in Input Loop choledochojejunostomy, about15minutes long,The two groups are compared to the operative time were significantly different, t=2.1781, P<0.05. A postoperative white blood cell count and neutrophil percentagewere higher than group B (P<0.05) and higher than normal. The two groups of experimental dogs after surgery serum bloodof TP, ALB, were lower than normal in group A was lower than group B, two groups TP, ALB, respectively, compared to thedifference was statistically significant (P<0.05).2. To measurement groups cholangioenterostomy the diameter,Mean±standard deviation size, Compare A1group:(2.26±0.12) cm in group A2:(2.19±0.11) cm, B1group:(2.21±0.13) cm in group B2:(2.33±0.13) cm.Between the four group compared to the anastomotic diameter difference (P>0.05).3.1four group during surgery to extract the bile bacterial culture to culture results were negative.Group4beagle dogs in the post-Choledochojejunostomy Bile bacteria detected were high, the Al group:53%of group A2:74%, group B1:27%, B2:46%.3.2Al group of Gram-negative bacteria detection rate of62%, Gram-positive bacteria detection rate of44%in group A2were86%and62%. The two groups of Gram-negative bacteria compared to χ2=7.48, P<0.05. Al group of bacteria detection rate lower than A2group;The two groups of Gram-positive bacteria compared to χ2=7.48, P>0.05, A2, group infection rate compared with the A1group, but no statistically significant difference.3.3B1group of gram-negative bacteria detection rate of42%, Gram-positive bacteria detection rate of12%in group B2were64%and28%. Two groups of Gram-negative bacteria compared to χ2=4.86, P<0.05, compared to two groups of Gram-positive bacteria χ2=4.00, P<0.05, significant difference in group B2Gram-negative bacteria and gram-positive bacteria, the detection rate higher than the Bl group.3.4A1group of Gram-negative bacteria detection rate of62%detection rate of44%of Gram-positive bacteria, the B1group were42%,12%. Two groups of Gram-negative bacteria compared to χ2=4.01, P<0.05, compared to two groups of Gram-positive bacteria χ2=12.70, P<0.05, significant difference A1group of Gram-negative bacteria and gram-positive bacteria, the detection rate higher than the B1group.3.5Group A2and the gram-negative bacteria-positive rate was86%, Gram-positive bacteria detection rate of62%in group B2were64%and28%.Two groups of gram-negative bacteria compared to χ2=6.45, P<0.05, compared to two groups of Gram-positive bacteria χ2=11.68, P<0.05, significant difference, A2, group of gram-negative bacteria and gram-positive bacteria-positive rate than B2group.Conclusion:1. Roux-en-eholedoehojejunostomy group surgery with longer operation time than Application of Jejunum Ligation in Input Loop choledochojejunostomy. 2. Post-Choledochojejunostomy within7days of experiments with dogs will have different degrees of infection, Group Roux-en-eholedoehojejunostomy than group Application of Jejunum Ligation in Input Loop choledochojejunostomy infection was severe, but they will not cause severe organ dysfunction.3. Biliary bacterial culture was positive and Gram-negative mainly in group Roux-en-eholedoehojejunostomy and group Application of Jejunum Ligation in Input Loop choledochojejunostomy in post-operative. Roux-en-eholedoehojejunostomy post-operative treatment group (group A1) bile bacterial culture positive rate than the Application of Jejunum Ligation in Input Loop choledochojejunostomy post-operative treatment group (group B1); Roux-en-eholedoehojejunostomy post-operative control group (A2)(B2) bile bacterial culture positive rate than the control group Application of Jejunum Ligation in Input Loop choledochojejunostomy after surgery. Roux-en-eholedoehojejunostomy post-operative treatment group (group A1) than the control group (A2) bile bacterial culture positive rate is low; Application of Jejunum Ligation in Input Loop choledochojejunostomy post-operative treatment group (group B1) than the control group (B2), bile bacterial culture-positive rate is low.4. Biliary tract infection rate of the postoperative group Application of Jejunum Ligation in Input Loop choledochojejunostomy lower in group Roux-en-eholedoeho-jejunostomy in the post-Choledochojejunostomy,post-Choledochojejunostomy biliary tract infection rate of traditional Chinese medicine Dachaihutang treatment group than the control group.