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Microstructural and ultrastructural changes in the healing process of bile duct trauma


   OBJECTIVE: To explore the mechanism of benign biliary stricture caused by bile duct trauma.METHODS: A model of trauma of the common bile duct was established in 28 dogs and then repaired.The anastomotic tissues were taken on 3 days, 1 week, 3 weeks, 3 months, and 6 months respectivelyafter operation and examined by using light microscopy and electromicroscopy. Macrophage. transforminggrowth factor beta I (TGF-β1) and α-smooth muscle actin (α-SMA) were studied immunohistochemically.RESULTS: The mucosal epithelium of the common bile duct restored poorly, chronic inflammation lastedfor a long time, fibroblasts proliferated actively, extracellular matrix overdeposited, and myofibroblastsfunctioned actively during the whole healing process. Immunohistochemical test showed a high expressionof macrophage, TGF-β1 and α-SMA during the healing process lasting a long duration. Macrophages werefound in the lamina propria under mucosa, TGF-β1 in the granular tissue, fibroblasts and endothelial cellsof blood vessels, while α-SMA in the myofibroblasts and smooth muscle tissue.CONCLUSIONS: The healing of the bile duct is in the mode of overhealing. Myofibroblast is the maincause for contracture of scar and stricture of the bile duct. The high expression of macrophage, TGF-β1and α-SMA is closely related to active proliferation of fibroblasts, extracellular matrix overdeposition andscar contracture of the bile duct.……