= Abstract =
j:: o}.2.J J!j- : ;(1] 4 ii ~] 2 §.. 1998 \1
An Experimental Animal Model of Anomalous Pancreaticobiliary Duct Union
Seok Joo Han, M.D., Hang- Seck Chang, M.D., Jong-Sung Kim, D.V.M.**, Jin-Soo Han, D.V.M.**, Hogeun Kim, M.D*. and Eui Ho Hwang, M.D.
Department of Surgery and Pathology*, Yonsei University College of Medicine
and Department of Laboratory Animal Research**, Samsung Biomedical R esearc.h Institute Seoul, Korea
The anomalous pancreaticobiliary duct union (APBDU) might cause the forma- tion of choledochal cyst and malignancies of hepatopancreaticobiliary system.
The purpose of this study is to make an experimental animal model of APBDU similar to that of human. One to two-month-old Mongrel dogs (n= 12) were di- vided into two groups; the control group (n = 2) had a sham operation performed, and in the experimental group (n = 10) the end of distal ' common bile duct (CBD) was anastomosed to the side of the dorsal pancreatic duct making APBDD. Serum was obtained for chemical analysis on the 10th postoperative day. The dogs were sacrificed at the 5th week (n=3), the 6th week (n = 3), the 7th week (n = 2), the 8th week (n=2) and the 6th month (n=2) after the exper- imental surgery. With sacrifice, operative cholangiogram was taken, and bile juice was obtained for chemistry and bacterial culture. The en-bloc specimens of the hepatopancreaticobiliary system were removed for microscopic examination.
Serum and bile juice amylase levels were elevated in the experimental group(n = 10), but not in the control group(n = 2). Operative cholangiograms of control group revealed no evidence of bile duct dilatation.. On the other hand, the bile duct in the experimental group was markedly dilated without any evidence of stenosis at the anastomosis site (n=lO). Histologic examination of the hepatopancreaticobiliary system in the experimental group resembled the findings of choledochal cyst in human. The APBDU of this animal model can produce bile duct dilatation by pancreaticobiliary reflux. We think that this ani- mal model can be potentially promising for the research about the APBDU asso-
- 100-
ciated hepatopancreaticobiliary diseases.
Index Words: Anomalous pancreaticobiliary duct union, Choledochal cyst, Experimental animal model
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Choledocho-pancreaticostomy
Fig. 1. a) Normal anatomy of canine pancreato-biliary system: Common bile duct opens to duodenal lumen conjoined with ventral pancreatic duct. Dorsal pancreatic duct opens about 3 cm distal to ventral pancreatic duct. b) Schematic diagram of the current experimental procedure .
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Table 1. Comparison of the Diameter of the Common Bile Duct between Control and Experimental Group.
Diamter of CBD
Control group (n=2)*
Experimental group (n= 10)+
.
Abbreviation: CBD; common bile duct, harvest
*: mean value
+: mean value + SD
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Preop (mm ) DOH (mm )
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Fig. 2. Operative cholangiogram; a. Control group, showing normal bile duct. b. Experimental group, show- ing successful formation of anomalous pancreaticobiliary duct union without stenosis. Good drainage of dye into duodenum and definite dilatation of the bile duct is noticed (postoperative 5th weeks) .
- 103 -
Table 2. Comparison of Chemical and Microbiologic Analysis of Serum and Bile between Control and Experimental Group
Serum
Bilirubin (mg/ dl) SGOT(U/L)
SGPT(U/L) ALP(U/L)
Amylase(IU/ L) Bile-Amylase
GB(lU/L) CBD(lU/L)
Bacterial Culture of Bile
Control group (n = 2) POD:It 10 DOH
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0.25 33.0 23.0 147.5 402.5
392.5 391.0
(-)
Experimental group (n=10)
POD:It 10 DOH
0.22 + 0.01 35.0 + 14.8 28.5 + 4.6 755.8 +459.6 758.5 + 289.6
0.18+ 0.00 30.8 + 4.8 30.6 + 12.5 187.9 + 84.7 742.0 + 350.9
43343.1 + 33461.2 43347.2 + 33021.1
E. coli, . ) ( n = 1) Ent. lecallS
Abbreviation: POD:j:j: 10; the 10th postoperative day, DOH; the day of harvest, GB; gallbladder, CBD;
common bile duct, E. coli; Escherichia coli, Ent. fecalis ; Enterococcus fecalis control group: mean value
experimental group: mean value + SD
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