保胆手术中胆囊壁浆肌层缝合的动物实验研究

Experimental studies on seromuscular anastomoses of gallbladder’s wall in gallbladder-preserving cholecystolithotomy

摘要:

目的 探讨保胆手术中胆囊壁浆肌层缝合修复胆囊的可行性及其优缺点。方法 取实验兔36只雌雄各半，随机分成3组，其中为胆囊壁间断浆肌层缝合组14只、胆囊壁间断全层缝合组14只以及对照组8只。该研究设置对照组只为观察在同等的麻醉、饮食和饲养环境因素条件下胆囊有无结石形成或其他变化，进行统计学数据分析时，不予分析。各组兔按术后7 及21 d各取兔一半剖腹观察腹腔情况，并取胆囊缝合处组织，分别行HE染色及Masson染色进行病理学检查。 结果 ①术后所有实验兔均无胆漏；②病理切片表明浆肌层缝合及全层缝合在术后7 d缝合处黏膜已愈合，术后21 d缝合处胶原纤维融合；③间断浆肌层缝合组和间断全层缝合组术后缝合口处组织胆囊壁厚度、炎症反应、成纤维细胞增生情况与胶原纤维含量比较,经统计学分析，差异均无显著性。 结论 ①用兔可以制作胆囊壁浆肌层缝合及全层缝合的模型；②实验证明胆囊壁间断浆肌层缝合与间断全层缝合同样安全、可行。

Abstract:

【Objective】 To explore the feasibility of seromuscular anastomosis of gallbladder’s wall in rabbit. 【Methods】 The thirty-six rabbits were divided into three groups on randomization, seromuscular anastomosis group (n=14), whole-layer anastomosis group (n=14) and control group(n=8). Each rabbit was processed in group in advance to observe the abdominal cavity and the gallbladder was taken postoperative days 7 and days 21, respectively. The sutured tissue was send to pathological examination. 【Results】 ①After postoperative, all experiment rabbits did not have the bile leakage or the abdominal cavity infects; ②The pathological section showed that the mucosa of suture recovered in postoperative days 7, the collagen fibers of suture had been crossed and blending in postoperative days 21; ③Seromuscular anastomosis group and whole-layer anastomosis group after postoperative, the gallbladder wall dropsy situation, inflammation responded (cell proliferation situation, and collagen fiber content were compared without statistical significance. 【Conclusions】 ①The model of suture the gallbladder wall by seromuscular anastomosis and whole-layer anastomosis can be established with rabbits; ②This experiment proved that is feasibility and safety to suture the gallbladder wall by seromuscular anastomosis and whole-layer anastomosis.