Changes of physiological functions and local tissue of biliary stricture injury in different stages

Objective To explore the optimal timing of operation for injurious biliary stricture(IBS) by observing dynamically changes of local tissue and systemic physiological function after biliary stricture injury in different stages.Methods Using dogs to establish the animal model of IBS,observe the changes of morphology and pathology of bile duct,and the liver function in different periods.Results After bile duct obstruction,the proximal bile duct dilated rapidly because of the increased bile duct pressure.The diameter of the bile duct dilated to(9.2±1.8) mm in the 5th day,and then to(18.91±1.85) mm in the 15th day.The injurious bile duct had the acute inflammation change.In the early time(in 10 days),inflammatory cell infiltration increased,the mucous edema aggravated,the pipe wall dropsy accumulation,heaviest by the 5th day.In the later period(10-30 days),inflammatory cell infiltration reduced,bile duct wall turned fibroplasias by the inflammatory edema,obviously in the 15th days.During the biliary obstruction,the liver function showed that the bilirubin reached the highest level in the early(BDL5 group),then presented a platform time,even mild setback,and then rised extremely in the last stage of the experiment(BDL30 group),the similar changes was also appeared in the enzyme indexes ALT and AST.It appeared a decline after a mild rise at the 20th day of obstruction and showed the phenomenon of bilirubin-enzyme separation.Conclusion Acute obstruction of bile duct injury in the early(10 days) can lead to the rapid increase in bile duct dilatation,hepatic dysfunction,local inflammation and edema of bile duct damage,followed by compensatory changes in the body there,20 days after the liver decompensation occurs,while bile duct damage local tissue shows fibrosis of hyperplasia adhesion,so we thinks the period between 10 and 20 days after acute bile duct injury is good time for the surgery.