| As an effective oncotherapy modality, hyperthermia has made rapid pro-gress in recent years. The treatment of cholangiocarcinoma by hyperthennia re-mains a challenging problem at present, and the research on safe heat dose of biliary tract is little. This research is a pilot safety study about the method of biliary tract intraluminal hyperthennia by perfusion of warmed saline solution, and the degree of heat injury was evaluated by analyzing the cholangiographic and histomorphological changes of bile duct after hyperthennic perfusion, which will give some available reference about hyperthermia of cholangiocarcinoma.Materials and Methods1. Animals, equipment and supplies1. 1 Animals subjects Ten healthy dogs, weight 14 ~ 20kg, provided by animal center of the second affiliated hospital of China Medical University, were randomly assigned into three groups: (1) 43 /30 min group(n =4, 2h 1W 2W.4W) , (2) 45 TC/30 min group (n =4, 2h,lW 2W 4W) , (3) the control group (n=2) .1.2 Equipment and supplies1. 2. 1 Main equipments Thermostatic waterbath box, thermistor-meter thermometer (precision; 0. 2 ) , 5F catheter, aspirater, surgical instruments, X-ray fluoroscopic machine, etc.1.2.2 Drugs Thiomebumal Sodium, iodine tincture, 75% alcohol, normal saline solution, penicillin, methylglucamine diatrizoate, etc.2. Methods2.1 Adjusting the temperature of perfusate Mimicking practical perfusionprocedure before operation, and adjusting the temperature of thermostatic water-bath box, keep the temperature of perfusate out of catheter at 43 or 45 .2. 2 Make animal surgical operation models "The animals were anesthetized by 30mg/kg thiopental sodium. Open abdominal cavity and insert catheter into crotch of left and right hepatic duct via duodenal papilla, then perform cholan-giography. Perfusing wanned saline solution into the common bile duct (CBD) via catheter to heat the CBD for 30 minutes. The temperature of perfusion fluid are monitored by thermistor-meter thermometer and keeping the temperature at 43 0.2 (43 group) or 45 0. 2 (45 group) throughout the perfusion procedure.2.3 Secondary cholangiography, make specimen The animals were given a secondary cholangiography and then were sacrificed immediately at 2 hours, 1 week, 2 weeks, 4 weeks following hyperthermia, respectively. The CBD specimens were obtained, then were fixed by 10% formalin or 2. 5% glutaraldehyde respectively. Make light microscopic ( LM ) sections and transmission electron microscopic (TEM) sections, then observed sections by LM and TEM respectively.Results1. Result of cholangiographyCholangiography clearly showed anatomic forms of biliary tree. Either 43 group or 45 group, cholangiography revealed that all biliary tracts lumen were unobstructed and no stricture.2. Histological changes of specimensNormal bile duct wall was composed of mucosa, muscular layer and adven-titial coat, each layer boundary was clear. Mucosa of 43 group specimens re mained essentially intact, and epithelial cells were normal in shape; specimen of 2h showed acute inflammation, monocytes and neutrophilic leukocytel infiltrated proper layer and muscular layer,capillary dilated and congested slightly; inflam-mation alleviated markedly after one week, and specimen of four weeks had already no difference from normal specimens. Specimen of 45 /2h showed se vere acute inflammatory reaction, endothelium revealed degenerative necrosisand fell off in most areas of the bile duct, a large amount of inflammatory cells infiltrated proper layer and muscular layer, capillary dilated and congested markedly. Specimens of 45 group gradually transited into chronic inflammation after 1, 2 and 4 weeks, epithelium mucosae recovered gradually, fibrous tissue proliferated, and bile duct wall thickened slightly.3. Ultrastructural changes of specimensNormal endothelial cells of bile duct were cellula columnoepithelialis, with abundant microvilli on the surface. Cytoplasm was well-distributed, mitochondriae were abundant, crista...
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