Intermittent sampling of portal venous blood and bile from guinea pigs

A technique is described for intermittent collection of portal venous blood from guinea pigs through a catheter advanced from an ileal tributary of the cranio-mesenteric vein into the portal vein and for the collection of bile from a catheter in the gallbladder after ligature obstruction of the common bile duct.     

腹腔镜胆囊切除术（LC 术）致胆管损伤的诊治体会

摘要目的：总结腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC 术）中胆管损伤的诊治体会。方法：回顾19 例LC 术致胆管 损伤病例的临床资料,分析其发生的类型及原因,并总结其诊断和治疗要点。结果：19 例患者中,1 例发生在左右肝管汇合以上处 损伤,2 例发生胆总管缺损伤,3 例发生胆总管横断伤,5 例发生胆总管侧面伤,3 例发生胆总管钳夹但未切断,1 例发生右肝管损 伤,4例发生胆囊管残端漏。治疗方法应视胆管损伤类型的不同而不同。采用断端处胆管端端吻合,同时放置T 管引流、单纯胆总 管T 管引流、开腹去除误夹夹子、ERCP检查放置鼻胆管引流及胆肠Rouxeny 吻合术。胆肠Rouxeny吻合术是临床上最常用的修 补胆道损伤的手术方法。随访6 个月～18 年,恢复好,无1 例死亡。结论：胆管损伤是LC 术最常见的并发症之一,规范的操作及 手术适应症的掌握能减少其发生。一旦出现胆管损伤,及时诊断及正确处理能减少其不良后果。     

腹腔镜胆囊切除术（LC术）致胆管损伤的诊治体会

目的：总结腹腔镜胆囊切除术（1aparoscopiccholecystectomy,LC术）中胆管损伤的诊治体会。方法：回顾19例LC术致胆管损伤病例的临床资料,分析其发生的类型及原因,并总结其诊断和治疗要点。结果：19例患者中,1例发生在左右肝管汇合以上处损伤,2例发生胆总管缺损伤,3例发生胆总管横断伤,5例发生胆总管侧面伤,3例发生胆总管钳夹但未切断,1例发生右肝管损伤,4例发生胆囊管残端漏。治疗方法应视胆管损伤类型的不同而不同。采用断端处胆管端端吻合,同时放置T管引流、单纯胆总管T管引流、开腹去除误夹夹子、ERCP检查放置鼻胆管引流及胆肠Rouxeny吻合术。胆肠Rouxeny吻合术是临床上最常用的修补胆道损伤的手术方法。随访6个月～18年,恢复好,无1例死亡。结论：胆管损伤是LC术最常见的并发症之一,规范的操作及手术适应症的掌握能减少其发生。一旦出现胆管损伤,及时诊断及正确处理能减少其不良后果。     

A surgical model for studying biliary bile acid and cholesterol metabolism in swine.

Techniques were developed in young growing pigs to simultaneously collect and reinfuse bile. Silastic cannulae were designed and surgically implanted in the common bile duct and the duodenum. Direct sampling of the hepatic bile was achieved by bypassing the gallbladder. The techniques allowed for steady-state studies of hepatic function to be conducted in conscious swine in two different studies. Pigs, thus surgically modified, can serve as an appropriate model for physiologic, pharmacologic, and nutritional research that involves bile sampling.     

Effect of bile on vitamin B12 absorption.

The standard double-isotope Schilling test was used to study vitamin B12 absorption in seven patients with obstructive jaundice and 10 with T-tube bile duct drainage after cholecystectomy and bile duct exploration. In three and five of these patients respectively absorption was impaired. In the second group six patients were restudied after removal of the T tube, and in each case absorption was improved. Similar results were obtained after bile duct ligation in rats. Bile exclusion produced a 50-60% reduction in renal and hepatic uptake of vitamin B12 from the intestinal lumen. The malabsorption was corrected by replacing bile. These studies suggest that bile plays a part in the normal absorption of vitamin B12.     

胆总管内注射无水乙醇致胆道闭锁动物模型的建立

目的应用胆总管内注射无水乙醇建立SD大鼠胆道闭锁模型。方法将SD雄性大鼠随机分为实验组和对照组,在实验组中经静脉留置针插入胆总管注入无水乙醇,对照组注入生理盐水。观察SD大鼠的生化及病理结果。结果在实验组中SD大鼠根据病理及生化检测分为肝功能持续恶化组和肝功能修复组,肝功能持续恶化组在8周以后生化明显高于对照组及肝功能修复组。常规HE染色及SMA、Masson染色也出现明显变化。结论胆总管无水乙醇注射诱导胆道闭锁模型是一种可靠的动物模型,此动物模型会帮助人们进一步研究胆道闭锁提供更多的研究手段。     

A novel bile duct cannulation method with tail cuff exteriorization allowing continuous intravenous infusion and enterohepatic recirculation in the unrestrained rat.

A variety of bile duct cannulation methods have been used in the study of biliary excretion in the rat. We now report the validation and use of one such method. In this method, the common bile duct and duodenum were cannulated, the free ends of the cannulae tunnelled through the abdominal wall, passed through a trochar and exteriorized at the ventral aspect of the tail. A purpose-designed stainless steel tail cuff was then attached, to protect the cannulae from the rat. The cannulae were passed through the top of a metabolism cage and attached to a dual swivel that allows the rat freedom of movement within the metabolism cage. Where necessary an additional cannula could be placed in the femoral vein to allow infusion of test material or blood sampling. The results demonstrate that the method is robust and that its use allows a reliable correlation between surgically prepared and intact animals, as physiological parameters are allowed to return to normal prior to inclusion of the animals in the study. The technique allows the animals a great deal of freedom and, as such, is considered to minimize stress associated with the procedure. This fact is reflected in the reliability and reproducibility of the data obtained over the wide range of studies that have been conducted using this method. This method has been in use for over 4 years at Inveresk and this paper describes the authors' experience with the method to date.     

Carbohydrate absorption in the rat small intestine following ligation of the bile duct

Active transport of free glucose, and glucose released from maltose and starch hydrolysis (F-, M-, and S-glucose, respectively) was investigated in vitro in the rat small intestine 7 and 14-17 days after the ligation of the common bile duct or after the laparotomy (control). The relative role of the ileum (its proximal portion in particular) in active transport of F- and M-glucose was enhanced following ligation of the common bile duct as compared with the control (laparotomy). The active transport of S-glucose was relatively low in the control and actually absent after the ligation of the common bile duct. The findings seem to reflect adaptive-compensatory responses of intestinal mucous membrane to insufficiency of the lumen digestion of carbohydrates due to exclusion of bile from the process.     

不同术式的经内镜下行乳头括约肌切开术（EST）对肠胆反流的影响

目的：目前认为,十二指肠胆道反流是引起胆道反复感染,进而导致胆道结石再发和胆道狭窄的原因之一。近年来应用以内镜下逆行胆胰管造影术（endoscopicretrogradecholangiopancreatography,ERCP）为基础的微创治疗胆总管结束的技术开展颇为广泛。它主要包括ERCP、Oddi括约肌切开术（endoscopicsphincterotomy,EST）、十二指肠乳头球囊扩张术（endoscopicpapillarybal—Iondilation,EPBD）、胆管结石碎石取石术、胆总管支架植入术和鼻胆管引流术六大技术。本文主要研究了采用不同术式的EST,即EST中切口和EST小切口＋EPBD术,在术后早期对患者十二指肠胆道反流的影响。方法：63例胆总管结石患者,男30例,女33例,予行经内镜下逆行的胆胰管造影（ERCP）后分别采用不同术式EST,术后安放胆总管引流管。术后l周留取胆汁采用口服核素和测定胆汁中的胃蛋白酶I、II的浓度,对十二指肠胆道反流进行定量和定性的测定。结果：EST中切口术组、EST小切口＋球囊扩张（EPBD）组分别与无EST组相比,年龄和性别无统计学意义（P=0．07,P=0．416）。行EST中切开和小切开＋球囊扩张患者胆汁中的锝计数明显高于无EST组,且这两组不同术式的患者锝计数存在显著的统计学差异（P〈0．05）。行EST中切口者、EST小切口＋球囊扩张术者胆汁中的PGII质量浓度明显低于无EST组（P〈0．05）,但是EST中切口者和EST小切口＋球囊扩张术后两组间胆汁中PGII的质量浓度无统计学差异。结论：行EST中切口取胆总管结石的患者在手术早期较易发生十二指肠胆道的反流。因此,建议对于胆总管结石患者尽量选择行EST小切口＋球裳扩张术（EPBD）的手术方式。     

A light and transmission electron microscope study of hepatic portal tracts in the rhesus monkey (Macacus rhesus)

This study reports on morphological features of hepatic portal tracts in the liver of a rhesus monkey. The light microscope shows that the number of each type of principal component comprising a portal tract varies but that there are usually one to five lymphatics, one bile ductule, one bile duct, one arteriolar and one arterial branch of the hepatic artery, and one hepatic portal vein. Bile ductules, in cross section, have 6-10 cells (mostly low pyramidal, but with a few cuboidal) bordering the lumen, an outside diameter of from about 20 to 25 microm, and a luminal diameter of from 2 to 10 microm. Bile ducts, in cross section, have more than 10 cells (about equal numbers of low pyramidal and cuboidal) bordering the lumen, an outside diameter greater than 25 microm and a luminal diameter of greater than 10 microm. The term "pyramidal" has not previously been applied to the cells of the ductules and ducts. The monkey tracts show several cytological features previously undescribed, viz., abortive cilia and basal bodies in the duct cells, abortive cilia in the ductule cells, and an occasional aggregation of ribosomes in arterial endothelial cells. They also show a major histological feature previously mentioned but not illustrated, viz., bundles of nerve processes which exhibit a preferential location, i.e., proximity to the arterioles and arteries.     

Improved method for bile collection in unrestrained conscious rats.

We describe an improved method for continuous collection of bile from unrestrained rats. Use of an externally accessible, continuous-loop cannula when cannulating the common bile duct allows for full recovery from anesthetic effects and maintenance of a normal bile salt pool until the cannula loop is cut. Bile resulting from the cut cannula is diverted into a surgically implanted glass collection vessel and removed periodically via an externalized sampling port. Bile flow over a 24-hour collection period averaged 0.98 +/- 0.04 ml/hr (Mean +/- SEM, n = 9) with no gross pathological changes noted upon necropsy. This technique offers the capability of reestablishing conditions as close to physiologic as possible postsurgery to minimize potential artifacts during bile collection.     

四氯化碳、酒精与四氯化碳联合、胆管结扎致SD大鼠肝纤维化病理学比较

目的研究四氯化碳、酒精与四氯化碳联合、胆管结扎致SD大鼠肝纤维化模型肝脏的病理学改变,初步探讨肝纤维化发病机制。方法四氯化碳组SD大鼠以3 mg/kg的剂量（首次剂量加倍）皮下注射50%四氯化碳（四氯化碳∶橄榄油=1∶1）,每周2次,连续注射6周;酒精与四氯化碳联合组SD大鼠每日按照10 mL/kg剂量灌服酒精混合物（酒精∶吡唑∶玉米油=10 mL∶25 mg∶2 mL）,同时每周2次按0.3 mL/kg剂量给予腹腔注射四氯化碳∶橄榄油（1∶3）,连续造模60 d;胆管结扎组大鼠按10 mg/kg体重腹腔注射3%戊巴比妥钠麻醉,腹部皮肤消毒,无菌操作沿腹部正中线剪开腹腔,分离出胆管,在胆管近端和远端2处结扎胆管,28 d后结束实验。试验结束后麻醉动物,解剖取动物肝脏组织,用10%福尔马林固定,进行病理学检查。结果四氯化碳致SD大鼠肝纤维化模型表现为弥漫性脂肪肝、肝炎、肝纤维化;酒精与四氯化碳联合致SD大鼠肝纤维化模型表现为酒精性脂肪肝、肝炎、肝纤维化;胆管结扎致SD大鼠肝纤维化模型表现为胆管增生、肝炎、肝纤维化。结论这3种方法都可以引起大鼠肝脏发生纤维化,其中胆管结扎致SD大鼠肝纤维化造模方法适合于临床胆汁淤积所致肝纤维化的模型建立,其它两种方法适合于化学性、病毒性肝炎引起的肝纤维化模型的建立,可根据不同的实验目的选择不同的方法构建相应的动物模型。     

Studies on the microvascularization of the digestive tract by scanning electron microscopy of vascular corrosion casts. 2. Bile duct in guinea pigs.

The microvascularization of the bile duct was studied in 20 adult guinea pigs (Cavia porcellus) using microvascular corrosion casts in the scanning electron microscope. The main supplying and draining vessels are located in the adventitial layer; from there they form the subepithelial capillary network. The microangioarchitecture of the common bile duct is reminiscent of that of the cystic and hepatic ducts. The diameter of these ducts is 1,000 microns on average. The microvascular arrangement in the bile duct suggests a probable involvement of the capillaries in the absorption of bile hormones.     

The origin and significance of macrophages in thoracic duct lymph.

Efferent lymph collected from a thoracic duct fistula initially contains no macrophages. However, the surgical procedures used to insert plastic cannulae into efferent lymphatics incite a vigorous foreign body reaction leading to the contamination of collected lymph with significant numbers of these cells. A sensitive and specific assay for the presence of macrophages in lymphocyte populations was used to quantitate the degree of contamination in rats bearing thoracic duct cannulae. The origin of some of these contaminant cells from the peritoneal macorphage population was established by adoptive transfer of labelled peritoneal cells to cannulated recipients.     

The Eltringham Organ and a New Thoracic Gland: Ultrastructure and Presumed Pheromone Function (Insecta, Myrmeleontidae)

Elofsson, R. and Löfqvist, J. (Zoological Institute, University of Lund, S-223 62 Lund, Sweden.) The Eltringham organ and a new thoracic gland: ultrastructure and presumed pheromone function . Zool. Scr. 3 (1): 31–40, 1974.—Eltringham's organ is a club-like projection from the posterior margin of hind-wings of some myrmeleontid insects. It bears laterally directed setae, each having a specialized epidermal cell beneath, which gives off secretion into a sub-setal lumen. The lumen continues into the wall of the moat-like socket of the setae. Eltringham's organ fits into an excavation of the lateral body wall connected with the opening of a thoracic gland. The thoracic gland in these animals has not previously been described. It consists of a hollow tube, feebly developed in females. The tube wall houses two cell types: gland cells and cuticular cells. The latter form the cuticle of the general duct lumen and a specialized duct leading from each gland cell. The gland cells have a microvilli-filled cavity which collects the secretion. The thoracic gland produces a pheromone secretion whose distribution is aided by Eltringham's organ where present.     

Prevalence and pathological study on rabbit hepatic coccidiosis in Taiwan.

Five breeds of rabbits, which included the New Zealand, Californian, Spot, Rex and Angora rabbit, were found from a survey of 1,152 rabbits in Taiwan. The prevalence of coccidia in young rabbits (weaning-2 months old) was 95% to 100%. Adult female rabbits usually acted as carriers within the farm and transmitted the parasite to young rabbits, which caused severe infection with clinical signs and even death. Parasitism of hepatic coccidia (Eimeria stiedai) in the rabbit led to severe mortality. Numerous and scattered white nodules about 0.1 to 0.5 cm in diameter were seen on the liver surface and dark greenish mucoid exudate was found in intestinal lumen. Histopathologic lesions included hyperplasia of the bile duct epithelium with different developmental stages of coccidia within. Oocysts could be seen in the lumen, and granuloma tissues encircle the bile duct with infiltration of inflammatory cells. The other organs were not infected.     

The lymphatic bed of the liver in man and animal and its transformation in disordered bile outflow

The lymphatic bed has been studied in 141 hepatic preparations of the man, dog and white rat. Development of obturation in the common bile duct in the man and at modelling a similar process in the animals results in essential morphological adaptive-compensatory and destructive changes in the hepatic lymphatic bed. The adaptive-compensatory reconstruction is especially well seen at initial stages of the disease. It is manifested as a total dilatation of the bed, certain reserve elements get into work, the bed capacity increases. Then certain new structural units of the bed, collateral pathways develop. When the obturational process lasts long, certain destructive changes of the hepatic lymphatic bed elements take place. The change in the relief of endotheliocytes is their most characteristic sign. With increasing age of the patients the degree of the destructive rearrangements of the hepatic lymphatic bed increases. In the experiment carried out on the animals the lymphatic outflow from the thoracic duct is determined, being an indirect index of the hepatic lymph-forming function. An essential increase of the lymph volume, several times greater than in the control, gets from the duct into the venous bed. A connection is revealed between the morphological transformations of the bed components and its drainage function. The lymphatic bed of the liver performs also an active work concerning resorption and transport of bilirubin, its content in the organ rather increases, when the common bile duct is obturated.     

胆囊切除术医源性胆管损伤的处理

目的:探讨开腹胆囊切除术医源性胆道损伤的诊断、手术时机和手术方式的选择。方法:对18例胆道损伤进行分析总结:分别施行了胆管修补、T管引流术10例,保守治疗2例,Roux-en-Y胆肠吻合术6例。结果:3例术后过早拔管发生吻合口狭窄,再次手术。1例因梗阻性胆管炎并发肝功能衰竭、多器官功能衰竭死亡。1例因胆肠吻合术后并发消化道出血、肝昏迷死亡。余术后良好。结论:尽早发现及正确处理对提高疗效和预防术后胆管狭窄起着决定性的作用。术中发现胆管损伤立即行端端吻合加T管引流;术后数天发现或多次胆道修补术失败者,则宜行规范的Roux-en-Y胆肠吻合术。     

Quantitative modeling identifies critical cell mechanics driving bile duct lumen formation

Biliary ducts collect bile from liver lobules, the smallest functional and anatomical units of liver, and carry it to the gallbladder. Disruptions in this process caused by defective embryonic development, or through ductal reaction in liver disease have a major impact on life quality and survival of patients. A deep understanding of the processes underlying bile duct lumen formation is crucial to identify intervention points to avoid or treat the appearance of defective bile ducts. Several hypotheses have been proposed to characterize the biophysical mechanisms driving initial bile duct lumen formation during embryogenesis. Here, guided by the quantification of morphological features and expression of genes in bile ducts from embryonic mouse liver, we sharpened these hypotheses and collected data to develop a high resolution individual cell-based computational model that enables to test alternative hypotheses in silico. This model permits realistic simulations of tissue and cell mechanics at sub-cellular scale. Our simulations suggest that successful bile duct lumen formation requires a simultaneous contribution of directed cell division of cholangiocytes, local osmotic effects generated by salt excretion in the lumen, and temporally-controlled differentiation of hepatoblasts to cholangiocytes, with apical constriction of cholangiocytes only moderately affecting luminal size.