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Evaluation of the Effects of Bile on the Arterial Tonus in a Rabbit Model
Gökhan Temiz1, Candan Mezili1, Yiğit Özer Tiftikçioğlu1
1Department of Plastic Reconstructive and Aesthetic Surgery, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Kartal, İstanbul, Turkey; Department of Plastic and Reconstructive Surgery, Darıca Farabi General Hospital, Kocaeli, Turkey; Department of Plastic and Reconstructive Surgery, Department of Pharmacology, Department of Clinical Pharmacology, Department of Radiology, Department of Pathology, and Department of Plastic and Reconstructive Surgery, Ege University School of Medicine, Izmir, Turkey; and Department of Liver Transplantation, International Kent Hospital, Çiğli, İzmir, Turkey.
Background:
Hepatic artery anastomosis is an essential part of live-donor liver transplantation, and during this anastomosis, an unusual contact between bile and vessel ends is observed. In this study, the effects of this nonphysiological contact in a rabbit model were evaluated.
Methods:
The study was designed in 2 steps-in vitro and in vivo. Three groups were established for the in vitro study. In the first group, vessels were incubated in Krebs solution with 5% bile for 1 minute. In the second group, vessels were kept in Krebs solution with 5% bile for 5 minutes. Vessels in the control group were kept in Krebs solution without bile. All groups were examined for responses to vasodilator and vasoconstrictor agents in organ bath system. The specimens were evaluated immunohistochemically and histopathologically. In the in vivo step, microvascular anastomosis was performed bilaterally. Right carotid artery was anastomosed during bile contamination as study group, and left carotid artery was anastomosed without bile contamination as control group. Blood flow indexes were measured.
Results:
The results of the in vitro study revealed decreased responses to contractile and relaxing agents in the first study group compared with that of the control group (P < 0.0001). There was no response obtained in the second study group. The Doppler ultrasound results revealed no difference between preoperative and postoperative flow indexes (P > 0.05). There was no postoperative spasm in the study group. However, there was significant vasospasm in the control group (P < 0.05).
Conclusions:
Vessels exposed to bile have decreased contractile and relaxing responses, and this effect increases with exposure duration.
