Establishment of a monkey model for liver cirrhosis via common bile duct ligation: Lessons learned

Objective: To establish a cholestatic liver cirrhosis model in rhesus monkeys via bile duct ligation (BDL) and analyze the challenges and key considerations of this modeling method. Methods: Five rhesus monkeys were subjected to BDL surgery, a well-recognized method for inducing cholestatic liver fibrosis. Five months after surgery, the development of liver cirrhosis was evaluated using ultrasound imaging, pathological examination, and other relevant assessments. The success rate of modeling and causes of failure were summarized and analyzed. Results: Only 2 out of 5 rhesus monkeys developed biliary obstructive cirrhosis 5 months after BDL, which was confirmed by ultrasound imaging and pathology. The modeling failed in the other 3 monkeys, attributed to common bile duct stump rupture, extrahepatic bile duct anatomical variations, and large intrahepatic biliary cyst formation. The BDL-based monkey cirrhosis model was associated with high failure risk, long modeling duration, high cost, and heavy reliance on large-scale equipment. Conclusion: The establishment of rhesus monkey liver cirrhosis model by BDL has numerous uncertainties and limitations. It is crucial to comprehensively consider factors including surgical risks, anatomical variations, detection methods, and equipment dependence when selecting this modeling approach.