The microvascular supply of the biliary tree, the peribiliary plexus （PBP）, stems from the hepatic artery branches and flows into the hepatic sinusoids. A detailed three-dimensional study of the PBP has been perform...The microvascular supply of the biliary tree, the peribiliary plexus （PBP）, stems from the hepatic artery branches and flows into the hepatic sinusoids. A detailed three-dimensional study of the PBP has been performed by using the Scanning Electron Microscopy vascular corrosion casts （SEMvcc） technique. Considering that the PBP plays a fundamental role in supporting the secretory and absorptive functions of the biliary epithelium, their organization in either normalcy and pathology is explored. The normal liver shows the PBP arranged around extra-and intrahepatic biliary tree. In the small portal tract PBP was characterized by a single layer of capillaries which progressively continued with the extrahepatic PBP where it showed a morecomplex vascular network. After common duct ligation （BDL）, progressive modifications of bile duct and PBP proliferation are observed. The PBP presents a three-dimensional network arranged around many bile ducts and appears as bundles of vessels, composed by capillaries of homogeneous diameter with a typical round mesh structure. The PBP network is easily distinguishable from the sinusoidal network which appears normal. Considering the enormous extension of the PBP during BDL, the possible role played by the Vascular Endothelial Growth Factor （VEGF） is evaluated. VEGF-A,VEGF-C and their related receptors appeared highly immunopositive in proliferating cholangiocytes of BDL rats. The administration of anti-VEGF-A or anti-VEGF-C antibodies to BDL rats as well as hepatic artery ligation induced a reduced bile duct mass. The administration of rVEGF-A to BDL hepatic artery ligated rats prevented the decrease of cholangiocyte proliferation and VEGF-A expression as compared to BDL control rats. These data suggest the role of arterial blood supply of the biliary tree in conditions of cholangiocyte proliferation, such as it occurs during chronic cholestasis. On the other hand,the role played by VEGF as a tool of cross-talk between cholangiocytes and PBP endothelial cells suggests that manipulation of VEGF release and function could represent a therapeutic strategy for human pathological conditions characterized by damage of hepatic artery or the biliary tree.展开更多
AIM： To explore the influence of portal vein hemodynamic changes after portal venous arterialization （PVA） on peribiliary vascular plexus （PVP） morphological structure and hepatic pathology, and to establish a th...AIM： To explore the influence of portal vein hemodynamic changes after portal venous arterialization （PVA） on peribiliary vascular plexus （PVP） morphological structure and hepatic pathology, and to establish a theoretical basis for the clinical application of PVA. METHODS： Sprague-Dawley rats were randomly divided into control and PVA groups. After PVA, hemodynamic changes of the portal vein and morphological structure of hepatohilar PVP were observed using Doppler ultrasound, liver function tests, ink perfusion transparency management and three-dimensional reconstruction of computer microvisualization, and pathological examination was performed on tissue from the bile duct wall and the liver. RESULTS： After PVA, the cross-sectional area and blood flow of the portal vein were increased, and the increase became more significant over time, in a certain range. If the measure to limit the flow in PVA was not adopted, the high blood flow would lead to dilatation of intrahepatic portal vein and its branches, increase in collagen and fiber degeneration in tunica intima. Except glutamic pyruvic transaminase （GPT）, other liver function tests were normal. CONCLUSION： Blood with a certain flow and oxygen content is important for filling the PVP and meeting the oxygen requirement of the bile duct wall. After PVA, It is the anatomic basis to maintain normal morphology of hepatohilar bile duct wall that the blood with high oxygen content and high flow in arterialized portal vein may fill PVP by collateral vessel reflux. A adequate measure to limit blood flow is necessary in PVA.展开更多
With the developments of surgical skills and immunology, bile duct complications after liver transplantation have been reduced from half to less than one third, but the incidence of bile duct stenosis after transplant...With the developments of surgical skills and immunology, bile duct complications after liver transplantation have been reduced from half to less than one third, but the incidence of bile duct stenosis after transplantation is still as high as 17%.^1,2 During liver transplantation, bile ducts may be damaged in several ways, most of which affect directly or indirectly peribiliary vascular plexus （PVP） and lead to bile duct complications after operation. The complications are more common in hepatohilar bile ducts because of lack of collateral circulation and easily damaged blood supply^3,4 so that it is necessary to know the anatomical structure of PVP. This study explored the anatomical structure of hepatohilar PVP in rats and dogs using the three dimensional reconstruction technique of computer microvisualization with MoticBuaa3Dvol software and ink perfusion, transparency management.展开更多
BACKGROUND:Liver revascularization is frequently required during the enlarged radical operation for hilar cholangio carcinoma involving the hepatic artery.Researchers have carried out a number of experiments applying ...BACKGROUND:Liver revascularization is frequently required during the enlarged radical operation for hilar cholangio carcinoma involving the hepatic artery.Researchers have carried out a number of experiments applying partial porta vein arterialization(PVA)in clinical practice.In this study we aimed to establish a theoretical basis for clinical application o partial PVA and to investigate the effects of partial PVA on ra hilar bile duct and hepatic functions.METHODS:Thirty rats were randomly and equally assigned into 3 groups:control(group A),hepatic artery ligation+bile duct recanalization(group B),and partial PVA+bile duc recanalization(group C).Proliferation and apoptosis o rat hilar bile duct epithelial cells,arteriolar counts of the peribiliary plexus(PBP)of the bile duct wall,changes in serum biochemistry,and pathologic changes in the bile duc were assessed 1 month after operation.RESULTS:The proliferation of hilar bile duct epithelial cells in group B was greater than in groups A and C(P<0.01).No apoptotic hilar bile duct epithelial cells were detected in any of the groups.The PBP arteriolar counts of the hilar bile duc wall were similar in groups A and C(P>0.05),but the coun was lower in group B than in group A(P<0.01).No statistically significant differences in alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase and albumin were found in the 3 groups.The gamma-glutamyltransferase value was higher in group B than in groups A and C(P<0.01)The hepatic tissues of groups A and C showed no significan abnormality.Chronic inflammatory changes in the hilar bile duct walls were observed only in group B.CONCLUSION:Partial PVA can restore the arterial blood supply of the hilar bile duct and significantly extenuate the injury to hilar bile duct epithelial cells resulting from hepatic artery ligation.展开更多
基金MIUR grants PRIN 2005 (prot. 2005067975_001) to E. Gaudio and Biomedicina, Cluster C04, Progetto n. 5 to E.Gaudio-P.Onori MIUR grants PRIN 2005 (prot.No: 2005067975_002) to D. Alvaro and a VA Research Scholar Award, a VA Merit Award and the NIH grants DK58411 and DK062975 to Gianfranco Alpini
文摘The microvascular supply of the biliary tree, the peribiliary plexus （PBP）, stems from the hepatic artery branches and flows into the hepatic sinusoids. A detailed three-dimensional study of the PBP has been performed by using the Scanning Electron Microscopy vascular corrosion casts （SEMvcc） technique. Considering that the PBP plays a fundamental role in supporting the secretory and absorptive functions of the biliary epithelium, their organization in either normalcy and pathology is explored. The normal liver shows the PBP arranged around extra-and intrahepatic biliary tree. In the small portal tract PBP was characterized by a single layer of capillaries which progressively continued with the extrahepatic PBP where it showed a morecomplex vascular network. After common duct ligation （BDL）, progressive modifications of bile duct and PBP proliferation are observed. The PBP presents a three-dimensional network arranged around many bile ducts and appears as bundles of vessels, composed by capillaries of homogeneous diameter with a typical round mesh structure. The PBP network is easily distinguishable from the sinusoidal network which appears normal. Considering the enormous extension of the PBP during BDL, the possible role played by the Vascular Endothelial Growth Factor （VEGF） is evaluated. VEGF-A,VEGF-C and their related receptors appeared highly immunopositive in proliferating cholangiocytes of BDL rats. The administration of anti-VEGF-A or anti-VEGF-C antibodies to BDL rats as well as hepatic artery ligation induced a reduced bile duct mass. The administration of rVEGF-A to BDL hepatic artery ligated rats prevented the decrease of cholangiocyte proliferation and VEGF-A expression as compared to BDL control rats. These data suggest the role of arterial blood supply of the biliary tree in conditions of cholangiocyte proliferation, such as it occurs during chronic cholestasis. On the other hand,the role played by VEGF as a tool of cross-talk between cholangiocytes and PBP endothelial cells suggests that manipulation of VEGF release and function could represent a therapeutic strategy for human pathological conditions characterized by damage of hepatic artery or the biliary tree.
基金Supported by Science and Technology Plan of Xiamen City,No.3502Z20064005Health Bureau of Xiamen City,No.WSk0521
文摘AIM： To explore the influence of portal vein hemodynamic changes after portal venous arterialization （PVA） on peribiliary vascular plexus （PVP） morphological structure and hepatic pathology, and to establish a theoretical basis for the clinical application of PVA. METHODS： Sprague-Dawley rats were randomly divided into control and PVA groups. After PVA, hemodynamic changes of the portal vein and morphological structure of hepatohilar PVP were observed using Doppler ultrasound, liver function tests, ink perfusion transparency management and three-dimensional reconstruction of computer microvisualization, and pathological examination was performed on tissue from the bile duct wall and the liver. RESULTS： After PVA, the cross-sectional area and blood flow of the portal vein were increased, and the increase became more significant over time, in a certain range. If the measure to limit the flow in PVA was not adopted, the high blood flow would lead to dilatation of intrahepatic portal vein and its branches, increase in collagen and fiber degeneration in tunica intima. Except glutamic pyruvic transaminase （GPT）, other liver function tests were normal. CONCLUSION： Blood with a certain flow and oxygen content is important for filling the PVP and meeting the oxygen requirement of the bile duct wall. After PVA, It is the anatomic basis to maintain normal morphology of hepatohilar bile duct wall that the blood with high oxygen content and high flow in arterialized portal vein may fill PVP by collateral vessel reflux. A adequate measure to limit blood flow is necessary in PVA.
文摘With the developments of surgical skills and immunology, bile duct complications after liver transplantation have been reduced from half to less than one third, but the incidence of bile duct stenosis after transplantation is still as high as 17%.^1,2 During liver transplantation, bile ducts may be damaged in several ways, most of which affect directly or indirectly peribiliary vascular plexus （PVP） and lead to bile duct complications after operation. The complications are more common in hepatohilar bile ducts because of lack of collateral circulation and easily damaged blood supply^3,4 so that it is necessary to know the anatomical structure of PVP. This study explored the anatomical structure of hepatohilar PVP in rats and dogs using the three dimensional reconstruction technique of computer microvisualization with MoticBuaa3Dvol software and ink perfusion, transparency management.
文摘BACKGROUND:Liver revascularization is frequently required during the enlarged radical operation for hilar cholangio carcinoma involving the hepatic artery.Researchers have carried out a number of experiments applying partial porta vein arterialization(PVA)in clinical practice.In this study we aimed to establish a theoretical basis for clinical application o partial PVA and to investigate the effects of partial PVA on ra hilar bile duct and hepatic functions.METHODS:Thirty rats were randomly and equally assigned into 3 groups:control(group A),hepatic artery ligation+bile duct recanalization(group B),and partial PVA+bile duc recanalization(group C).Proliferation and apoptosis o rat hilar bile duct epithelial cells,arteriolar counts of the peribiliary plexus(PBP)of the bile duct wall,changes in serum biochemistry,and pathologic changes in the bile duc were assessed 1 month after operation.RESULTS:The proliferation of hilar bile duct epithelial cells in group B was greater than in groups A and C(P<0.01).No apoptotic hilar bile duct epithelial cells were detected in any of the groups.The PBP arteriolar counts of the hilar bile duc wall were similar in groups A and C(P>0.05),but the coun was lower in group B than in group A(P<0.01).No statistically significant differences in alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase and albumin were found in the 3 groups.The gamma-glutamyltransferase value was higher in group B than in groups A and C(P<0.01)The hepatic tissues of groups A and C showed no significan abnormality.Chronic inflammatory changes in the hilar bile duct walls were observed only in group B.CONCLUSION:Partial PVA can restore the arterial blood supply of the hilar bile duct and significantly extenuate the injury to hilar bile duct epithelial cells resulting from hepatic artery ligation.
