| Objective To investive the impact of right hepatic artery on the recovery of hepatic lesion after internal drainage in rats with biliary obstruction,and provide a theoretical basis and experimental basis for the clinic,which can instruct the decision-making of treatment in clinic and improve the cure rate.Methods 55 Sprague-Dawley rats were (sortition) divided into three groups radomly: 15 rats were selected into the sham operative group(A);The biliary obstruction group(B) and The biliary obstruction associated with right hepatic arterial injury group(C) sekected 20 rats respectively. the common bile duct of rats in group B were ligated to establish the model of biliary obstruction and used the same method to ligate the common bile duct of rats in group C in addition to intersect right hepatic artery in the first operation.10 days later,group B and group C were carried out the internal drainage by a Epidural catheter,and group A only dissected the common bile duct and right hepatic artery.After the re-operation,we observed the general condition of health and Mortality was calculated in all rats,and blood simples from all the rats at each time phase to determine Liver functional indexes .30 days afer re-operation,all rats were performed the third operation.At operation,we observed the general change of hepatic and drawed blood from abdominal aorta to detect the arterial ketone body ratio(AKBR) of all rats.futhermore,the pathological sections,Electrin microscope and Immunohistochemistry were used to observe and examine information of hepatic letion and the expression intensity of Tarnsforming gorwth factorβ1(TGF-β1) in diffetent groups.Results (1)The rats in group B,C appeared light jaundice in the second day,and 5 to 10 days was the the peak time of jaundice of rats.The urine of rats was dark yellow,The stool was gray,Foodintake growed downwards and the body weight was lessen slightly.A rat died of bile leakage in group B and group C respectively.(2) At the re-operation,the hepatic had light conghution with surrounding organs and had cholestasis and engorgement in group B, but which had not the visible liver ischemia;While in group C,the hepatic,especially in the right hepatic had severe conghution with surrounding organs and also had apparent cholestasis and engorgement.Futhermore,there was Visible right liver ischemia in 2 rats of group C and 1 rat died of bleeding at the operation.(3) After the re-operation,2 rats died of bile leakage in group B,and 8 ones died in group C,which was higher than group B(P<0.05),and the causes mainly were hepatonecrosis or hepatophyma,then were pulmonary infection and bile leadage.Jaundice of the rest survival rats in group B,C decreased quickly after the re-operation,and 5 to 7 days after the re-operation there was not visible jaundice in the rats.The rats in group A had not jaundice after the operation,which also had not any death.(4) 30 days after the re-operation,the hepatic had not obviously conglutination,and the appearance and general shape of hepatic was normal in group A;The hepatic had light conglutination with surrounding organ in group B,and the appearance and general shape of hepatic also was nearly normal;In group C,the hepatic especially in the right hepatic had severe conglutination .Futhermore,there was vivible right hepatic ischemia in 3 rats,and liver ischemia in one,also there was liver hepatophyma in a rat.(5) The liver function of group A was normal; the total bilirubin(TBIL) and alkaline phoshatase(ALP) decreased quickly in group B and C,which recovered to normal in the 14th days after the re-operation and they had not discrepancy between the two group(p>0.05); The alanine aminotransferase(ALT) of rats in group B decreased quickly after the re-operation and recovered to normal in the 14th days.The albumin(ALB) of rats in group B was lower than that in group A within 2 weeks after the re-operation(p<0.05),but it recovered to normal in the 21th days after the re-operation(p>0.05); The ALT of rats in group C was higher than that in group A and B at each time phase(P<0.05),and which recovered slowly after the re-operation. The ALB of rats in group C was lower than that in group A,B at each time phase(p<0.05),and the tendency of its was decline.(6) The pathologic scopy of hepatic in all rats 30 days after the re-operation: In group A, the pathologic scopy of hepatic was normal; the right hepatic of rat in group B and the left hepatic of rat in group C had recovered to nearly normal in pathological section and Electrin microscope.In the hepatic lobules and portal area,there was only a small amount of inflammatory cells and TGF-β1 were lesserly expressed; while in the right hepatic of rats in group C,pathological examination section showed that the right hepatic has denaturation,fibrosis and hepatonecrosis.Especially,in portal area, fibrous tissue and bile ductules hyperplasia were apparente. It also showed that hepatic cellularedema, karyopycnosis,mitochondria dropsy and collagen fibershyperplasia in Disse cavity and Hepatocyte gap by Electrin microscope. TGF-β1 was strongly expressed in surrounding of central vein, portal area and zone of necrosis.(7)The AKBR of rats in group A and B was normal,and the AKBR of rats in group C was lower than that in group B and C,which is discrepancy(p<0.05).Conclusion (1) Right hepatic arterial injury will make the hepatic lesion in the rats with biliary obstruction more serious,which also can lead to liver ischemia and increase the mortality after the re-operation.(2) After re-operation,right hepatic arterial injury is disadvantage of the recovery of the hepatic function and energy metabolism of hepatic ,and which also can lead to hepatic fibrosis,hepatic ischemia,hepatonecrosis, hepatophyma ,hepatatrophia and so on.So RHAI is disadvantage of the recovery of the hepatic lesion which is caused by biliary Obstruction in rats.
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