Repair Of Bile Duct Injuries With Vascular And Stent: Experimental Study In Rabbits

Objective: The purpose of this experiment is to access the feasibility and safetyof repair severe bile duct injury with autologous vascular grafts by observedmorphology changes and animal survival situation and provide a new technique torepair clinical bile duct injury through the use of shift autologous vein segment.Methods: Twenty-four healthy adult local rabbits of weight3.0-3.5kg weredivided randomly into3groups (A,B and C),(n=8), A and B groups were donecholecystectomy and common bile duct resection (length of0.5or1.0cm) to make ofbile duct injury models. The group A was transplanted a length of0.5cm vein and thegroup B was transplanted a length of1.0cm vein of rabbit ear, and used a polyolefintube intravascular as a stent. Group C was only done cholecystectomy.After operationall animals were injected ceftriaxone sodium0.3g/day×3day. We observed thesurvival rate, diet, activity, liver function, liver and bile duct pathology changing inanimals after the operation. The specimens of blood were collected one week ofpreoperation, the first and the third month of postoperation to measure of alanineaminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, totalprotein, albumin, alkaline phosphatase enzymes. And3months postoperation theanimals were sacrificed to take liver and bile duct tissue to observe pathologicalchange and bile duct epithelial crawling in the endovascular grafts.Results：○1Animal survive: Two rabbits died in the group A, one died3dayspostoperation of bile leakage and bile peritonitis; the other died4days postoperationof bile leakage, bile peritonitis and intra-abdominal purulent infection(we found theintra-abdominal bile and pus moss by autopsy, the poor spirit and fever beforedeath).Two rabbits died in the group B also, one died2days postoperation of bileleakage,bile peritonitis (a lot of yellow-green liquid in the abdominal cavity); Theother died3days postoperation of bile leakage and abdominal infection (we seemuddy yellow-green fetid liquid by autopsy), The rest animals survived for3months.○2Postoperative diet:we fed the animals with nutrient solution(the glucose injection+Sodium Chloride injection+Compound Vitamin B+vitamin C) for1-3days and injected intravenous10%the glucose injection50ml+vitamin C0.25g+0.9%saline10ml,postoperative2-3days the animals increased nutrientsolution intake,whose vigor and activity was gradually recovered.All animals with nojaundice, stool color and urine color were significant deepen compared with thepreoperation.○3Blood biochemical indicators: there ware no significant changes inblood biochemistry postoperatively.○4Three months postoperation there were nosignificant changes and jaundice in the liver biopsy compared with those ofpreoperation；the biliary epithelial cells begin to form a monolayer in the grafts.Conclusions: The operation to repair the bile duct with autologous vascular andintraluminal stent is effective and feasible, it can be used to repair bile duct injury.