Through dog models of common bile duct obstruction (BDO), the contents of liver superoxide dismutase (SOD) and malondialdehyde(MDA) were measured 2,3,4 and 5 weeks after BDO. Results indicated that the hepatic MDA content was increased 2 weeks after BDO as compared with control group (P<0.01), the hepatic SOD content was decreased 3 weeks after BDO (P<0.05). When bile duct obstructing, these changed were more serious. The results suggest that liver has little ability to eliminate the superoxide free radicals after BDO, whereas the lipid peroxidation products increase. It may be one of the mechanisms of liver damage after BDO.
Objective To investigate whether intraductal electrocautery incision (IEI) could decrease the recurrence of post-liver transplant anastomotic strictures (PTAS) after conventional endoscopic intervention of balloon dilatation (BD) and plastic stenting (PS). Methods The clinical data of 27 patients with PTAS who were given endoscopic treatment of BD+PS or IEI+BD+PS in our hospital from January 2007 to October 2011 were reviewed retrospectively. Results The treatment of BD+PS was initially successful in 9 of 11 (81.8%) cases, but showed recurrence in 5 of 9 (55.6%). The treatment of IEI+BD+PS was initially successful in 14 of 16 (87.5%) cases, and the recurrence was observed only in 3 of 14 (21.4%). The total diameter of inserted plastic stents in IEI+BD+PS group was significantly greater than that in BD+PS group 〔(12±3.2) Fr vs. (8±1.3) Fr,P=0.039〕. All recurrences were successfully retreated by IEI+BD+PS. Procedure-related complications included pancreatitis in 5 cases (18.5%), cholangitis in 8 cases (29.6%), bleeding after EST in 1 cases (3.7%), which were all cured with medical treatment. No complications related to intraductal endocautery incision procedure such as bleeding and perforation were observed. Median follow-up after completion of endoscopic therapy was 22 months (range 1-49 months). Conclusions Intraductal electrocautery incision is an effective and safe supplement to balloon dilatation and plastic stenting treatment of PTAS, which can decrease the recurrence of anastomotic strictures in conventional endoscopic intervention.