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首页> 外文期刊>Iranian journal of medical hypotheses and ideas. >The human umbilical cord: A novel substitute for reconstruction of the extrahepatic bile duct
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The human umbilical cord: A novel substitute for reconstruction of the extrahepatic bile duct

机译：人的脐带：肝外胆管重建的新替代品

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Reconstruction of the extrahepatic bile duct following bile duct injury or defect is one of the most common challenges for hepatobiliary surgeons. There are currently a number of surgical strategies such as biliary-enteric anastomosis, end-to-end anastomosis and autologous tissue substitute. However, sphincter of Oddi dysfunction as well as biliary stricture may occur after surgical anastomosis. Also, insufficient tissue quantity remains a problem associated with the application of tissue substitute. Therefore, considerable attention has been attracted to explore a new replacement material of the bile duct for biliary reconstruction. The human umbilical cord (HUC) is abundant in resource and is convenient to collect, including two arteries and one vein, whose diameters are close to that of the common bile duct. In order to reduce immunogenicity (foreign-body reaction), cells and major histocompatibility complex (MHC) antigens can be removed from the HUC and the remaining tissue (extracellular matrix, ECM) can be used as a scaffold. The HUC provides a rich source of mesenchymal stem cells (MSCs). A current study has demonstrated that MSCs are able to differentiate into biliary epithelial cells in vivo and in vitro with low immunogenicity, which can be used as seed cells. The HUC might be a promising composite material of a scaffold (ECM) and seed cells (biliary epithelial cells), for bile duct replacement in situ without removal of sphincter of Oddi, or biliary stricture. In addition, the patients’ own umbilical cord without any foreign-body reaction can be directly banked for possible future use in bile duct reconstruction. Therefore, we hypothesise that the HUC may be a novel substitute for reconstruction of the extrahepatic bile duct.
机译：胆管损伤或缺损后肝外胆管的重建是肝胆外科医师最常见的挑战之一。当前有许多手术策略，例如胆肠吻合，端对端吻合和自体组织替代。但是，手术吻合后可能会发生Oddi括约肌功能障碍以及胆道狭窄。而且，组织量不足仍然是与组织替代物的应用相关的问题。因此，已经引起了相当大的关注，以探索用于胆道重建的新的胆管替代材料。人脐带（HUC）资源丰富且便于收集，包括两条动脉和一条静脉，其直径接近胆总管的直径。为了降低免疫原性（异物反应），可以从HUC中去除细胞和主要组织相容性复合物（MHC）抗原，并将其余组织（细胞外基质，ECM）用作支架。 HUC提供了丰富的间充质干细胞（MSC）来源。当前的研究表明，MSC能够以低免疫原性在体内和体外分化为胆道上皮细胞，可用作种子细胞。 HUC可能是一种有前途的支架（ECM）和种子细胞（胆管上皮细胞）的复合材料，用于原位胆管置换而不去除Oddi括约肌或胆管狭窄。此外，患者自身的脐带没有任何异物反应，可以直接储存起来，以备将来在胆管重建中使用。因此，我们假设HUC可能是肝外胆管重建的新型替代品。

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