Influence of biliary anastomosis on recovery from secondary biliary cirrhosis

Santos, José Sebastião dos; Kemp, Rafael; Andrade, Murilo Ferreira de; Neder, Luciano

doi:10.1097/meg.0b013e3283551fed

Cited by 6 publications

(6 citation statements)

References 40 publications

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“…Recanalization operation was performed with rats common bile duct isolated and ligated for 7 days. Via a laparotomy, the ligated distal end of the common bile duct was dissected, and an anastomosis was established between the common bile duct and the jejunum, which was sectioned 5 cm from the duodenojejunal angle [6].…”

Section: Animalsmentioning

confidence: 99%

Usefulness of diffusion derived vessel density computed from a simplified IVIM imaging protocol: An experimental study with rat biliary duct blockage induced liver fibrosis

Zheng

Zhong

et al. 2021

Magnetic Resonance Imaging

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Aim: Liver vessel density can be evaluated by DDVD (diffusion derived vessel density): DDVD(b0b1) = Sb0/ROIarea0 -Sb1/ROIarea1, where Sb0 and Sb1 refer to the liver signal when b is 0 or 1 (s/mm 2 ); ROIarea0 and ROIarea1 refer to the region-of-interest on b= 0 or 1 images.Sb1 and ROIarea1 may be replaced by Sb25 and ROIarea25 or Sb50 and ROIarea50 (i.e., by images of b=25 or 50 s/mm 2 ). With rat biliary duct ligation (BDL) model, this study assessed the usefulness of liver DDVD computed from a simplified IVIM imaging protocol.Materials and Methods: Male Sprague-Dawley rats were used, and 1, 2, 3, 4 weeks post BDL had rat number of 5, 5, 5,3 respectively. Partial recanalization (n=12) was performed with rats had BDL for 7 days and MRI was done mean 14 days after recanalization. Liver diffusion MR images were acquired using with a 3.0T magnet with a b-value distribution of 0, 30, 50, 75, 100, 150, 300, 700, 1000 s/mm 2 . DDVDmean (control rats n=6) was the mean of DDVD(b0b25) and DDVD(b0b50). IVIM fitting started from b = 0 with segmented fitting and a threshold b of 50 s/mm 2 (n=5 for control rats). Three 3-D space was constructed using PF, D slow , and D fast ; PF, D slow , and DDVD mean ; or PF, D fast , and DDVD mean .Results: BDL week 1, 2, 3, 4 rats and partial recanalization rats had mean liver fibrosis METAVIR score of 1.5, 2.4, 3.25, 3.7 and 2.42 respectively. The control rats and BDL rats (n=18) had a liver DDVD mean of 84.0±26.2 and 44.7±14.4 au/pixel (p<0.001). Each diffusion MRI parameter alone could not totally separate healthy livers and all fibrotic livers (n=30, BDL and BDL+ recanalization rats). All 3-D spaces totally separated healthy livers and all fibrotic livers. The mean relative distance between healthy liver cluster and fibrotic liver cluster was 0.331 for PF, D slow , and D fast ; Dfast, 0.381 for or PF, D fast , and DDVD mean ; and 0.384 for PF, D slow , and DDVD mean .Conclusion: A combination of PF, D slow , and D fast allows a total separation of all healthy livers and fibrotic livers, with the integration of DDVD improved the separation.

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Section: Animalsmentioning

confidence: 99%

Usefulness of diffusion derived vessel density computed from a simplified IVIM imaging protocol: An experimental study with rat biliary duct blockage induced liver fibrosis

Zheng

Zhong

et al. 2021

Magnetic Resonance Imaging

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“…In contrast, choledochojejunostomy (CJ) is a procedure that can be performed relatively easily, with basic microsurgical equipment. CJ has been used in experimental rat models to investigate issues such as the effect of different biliary drainage procedures, or the effect of biliary drainage on the liver [ 6 7 ].…”

Section: Introductionmentioning

confidence: 99%

The rat choledochojejunostomy model for microsurgical training

Lee

Hong

2016

Ann Surg Treat Res

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PurposeThe feasibility of a rat choledochojejunostomy (CJ) training model was investigated, as an introductory model to microsurgery for general surgeons.MethodsRoux-en-Y CJ was performed on 20 rats. Interrupted 10-0 prolene sutures were used to perform CJ. The animals were observed for 7 days and sacrificed and examined.ResultsThe rats were divided into 2 groups of 10 based on surgical order. The CJ time showed a significant decrease from 36.2 ± 5.6 minutes in group 1 to 29.4 ± 5.7 minutes in group 2 (P = 0.015). The bile leakage rate was 40% in group 1 and 10% in group 2. The survival time was 5.4 ± 2.2 days in group 1 and 7 days in group 2 (P = 0.049).ConclusionThe rat CJ training model is a feasible introductory model for general surgeons with no previous experience in microsurgery.

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“…O presente estudo, sabidamente, tem limitações metodológicas e, dentre outras, destacam-se o seu caráter retrospectivo de uma coorte; a experiência inicial com o tratamento pela via endoscópica (viés da curva de aprendizado); a possibilidade do viés de seleção de pacientes com maior risco direcionados ao tratamento minimamente invasivo e o emprego exclusivo de próteses plásticas para a maioria dos pacientes (geralmente de menor custo e de resultados clínicos inferiores em relação às metálicas auto-expansíveis), sobretudo aqueles com doença avançada e metastática (MOURA et al, 2016;ZORRON PU, 2015;TAYLOR;MCLEOD;LANGER, 2000). A análise crítica dos resultados pode, contudo, permitir a revisão crítica de algumas práticas, a confecção de protocolos clínicos e de regulação (SANTOS et al, 2012), além de reunir justificativas para a elaboração de estudos com novos delineamentos.…”

Section: Discussionunclassified

“…A incorporação de tecnologias e de práticas que permitam a combinação dos aspectos positivos de cada uma das técnicas estudadas é uma possibilidade na busca por melhores resultados clínicos e assistenciais e do melhor custo-efetividade para o tratamento paliativo dos TCBP. As anastomoses biliodigestivas e gastroenterológicas realizadas entre tecidos saudáveis, em que pese os refluxos enterogástrico e enterobiliar, assim como a contaminação que induzem, tanto no homem (SANTOS et al, 2005), quanto em modelos experimentais (DUTRA et al, 2008;KEMP et al, 2011;SANTOS et al, 2012), provavelmente, promovem o melhor trânsito alimentar e clareamento biliar, em relação às desobstruções proporcionadas pelas próteses. As próteses, que são corpos estranhos estáticos, habitualmente ancorados em tecido tumoral, o qual pode comprometer a peristalse por extensão da neoplasia e provocar obstrução, provavelmente, dificultam a drenagem de conteúdos de baixo fluxo e o clareamento de material líquido.…”

Section: Discussionunclassified

Estudo do custo-efetividade do tratamento paliativo dos tumores da confluência biliopancreática mediante comparação entre as abordagens laparotômica e endoscópica

Júnior¹,

Resende²

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Estudo do custo-efetividade do tratamento paliativo dos tumores da confluência biliopancreática mediante comparação entre as abordagens laparotômica e endoscópica Dissertação apresentada à Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, para a A Deus por dar-me a vida e seus propósitos. À querida família: minha mãe, Rosa Helena, meu pai, Jorge, meus irmãos Marcelo, Ana Teresa e Marco Tullio pelo amor, paciência, aprendizados moral, pessoal e profissional; pelos estímulos e por serem meu grande alicerce na vida. À minha amada Mariana, pelo carinho e amor constantes, pela paciência e incentivos sempre cedidos, além de me trazer novos objetivos e sonhos. Ao meu orientador, Prof. José Sebastião, pelos ensinamentos, incentivos e confiança. Aos grandes Mestres e exemplos na vida médica: meu pai Jorge Resende, tios José Resende (in memoriam) e Aluízio Prata (in memoriam) e professores João Gilberto

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Influence of biliary anastomosis on recovery from secondary biliary cirrhosis

Cited by 6 publications

References 40 publications

Usefulness of diffusion derived vessel density computed from a simplified IVIM imaging protocol: An experimental study with rat biliary duct blockage induced liver fibrosis

Usefulness of diffusion derived vessel density computed from a simplified IVIM imaging protocol: An experimental study with rat biliary duct blockage induced liver fibrosis

The rat choledochojejunostomy model for microsurgical training

Estudo do custo-efetividade do tratamento paliativo dos tumores da confluência biliopancreática mediante comparação entre as abordagens laparotômica e endoscópica

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