| Objective:To investigate the effect of biliary extra-drainage in rats with obstructive jaundice on liverfunction and liver regeneration after hepatectomy in order to provide a theoretical basis forclinical application.Methods:1. Animal grouping:90healthy SD rats (purchased from Changsha Kaifu DistrictXiangpin Biological Co., Ltd.), no matter male or female and weight350±20g, were keptin a clean environment. SD rats were free to be fed on food and water and the rhythm oflife was12hours a day. SD rats were randomly divided into three groups,(1) SO group: therats without obstructive jaundice after hepatectomy,(2) ID group: biliary internal-drainageon rats with obstructive jaundice after hepatectomy,(3) ED group: biliary extra-drainage onrats with obstructive jaundice after hepatectomy.2. Preparation of animal model:(1) SO group:10%chloral hydrate wasanesthetized rats by intraperitoneal injection, letting the white line into the abdomenthrough the middle of it and then finding the common bile duct. At last, the abdomen wasclosed after flipping the first hepatic portal.72hours later, disSOciating middle lobe of theleft liver, ligating the left lobe of the hepatic pedicle and then closing the abdomen afterhepatectomy.(2) ID group:10%chloral hydrate was anesthetized rats by intraperitonealinjection, letting the white line into the abdomen through the middle of it and then findingthe common bile duct. Lastly, the abdomen was closed after ligating by4-0silk. After72hours, going into the abdomen through the original incision, disSOciating the left lobe of liver, ligating the hepatic pedicle and then doing the hepatectomy, At the sametime, after biliary-enteric internal drainage abdomen was closed.(3) ED group:10%chloral hydrate was anesthetized rats by intraperitoneal injection, letting the white line intothe abdomen through the middle of it and then finding the common bile duct. In the last,the abdomen was closed after ligating by4-0silk. After72hours, going into the abdomenthrough the original incision, ligating the hepatic pedicle and then doing the hepatectomy,the abdomen was closed after biliary extra-drainage.3. Index detection: Six rats for each group would be killed after operation at each timepoint (0h,24h,48h,72h,168h) and then measuring the serum total bilirubin (TIBL),aspartate aminotransferase (AST), albumin (ALB) by using automatic biochemical analyzer.The rate of liver regeneration was measured by analyzing postoperative residual liverweight/body weight of rats. Staining the remnant of liver by HE and then observing thetissue mitosis of liver by using the light microscopy, counting the number of mitotic cells,which is the index of mitotic and expresses the immunohistochemical staining of PCNA.Results:1. The test of liver function after hepatectomy(1) Compared rats without obstructive jaundice to rats with obstructive jaundice: At thetime points (postoperative0h,24h,48h,72h,168h), compared the SO group with ID groupand ED group, there was almost no increase for TBIL with rats in the SO group which wassignificant lower than the last two groups of it, their differences were statistical significance(P＜0.05). At the time points (postoperative0h,24h,48h,72h,168h), compared the SOgroup with ID group and ED group, there was no visible decrease for AST with rats in theSO group which was significant lower than the last two groups of it, their differences werestatistical significance (P＜0.05). At the time points (postoperative0h,24h,48h,72h,168h),compared the SO group with ID group and ED group, there was almost no reduction forALB with rats in the SO group which was significant higher than the last two groups of it,their differences were statistical significance (P＜0.05).(2) Compared loss of bileto not loss bile in rats with obstructive jaundice: At the time points (postoperative0h,24h,48h,72h,168h), AST with ID group was lower and decreased more rapidly than AST of ED group. The differences between them were statistical significant (P＜0.05). At thetime points (postoperative0h,24h,48h,72h,168h), ID group of ALB was higher and rosefaster than it with ED group, the differences between them were statistical significant (P＜0.05).2. The assessment of liver regeneration after hepatectomy(1) Compared rats without obstructive jaundice to rats with obstructive jaundice: Comparedthe SO group with ID group and ED group, the ratio of remnant liver weight/body weightof rats in the SO group was higher after postoperative168h. There were marked remnantliver hyperplasia and high mitotic in the SO group. the difference of them were statisticalsignificance (P <0.05). The PCNA of rats in the SO group was higher than it of ID groupand ED group at the time points (postoperative0h,24h,48h). The differences werestatistical significant (P <0.05).(2) Compared loss of bile to not loss bile in rats withobstructive jaundice: The ratio of remnant liver weight/body weight of rats in the IDgroup was higher than it of the ED group after postoperative168h and the mitotic of the IDgroup was higher, as well. The differences were statistical significant (P <0.05). The PCNAof ID group was higher compared with the ED group at the time point (postoperative0h,24h,48h,72h), with the statistical significant difference (P <0.05).Conclusion:(1) Obstructive jaundice can inhibit the regeneration of rats’ residual liver after partialhepatectomy.(2) Rats with obstructive jaundice after partial hepatectomy which adopted biliaryextra-drainage could inhibit residual liver regeneration, however, not loss bile couldsignificantly improve post-hepatectomy liver function and promote residual liverregeneration. |
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