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Bile exclusion from the duodenum

Its effect on gastric and pancreatic function in the dog

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Abstract

The effect of diverting bile from the duodenum in four dogs with cholecystojejunostomy was studied using a double-marker perfusion technique. After the diversion procedure, a liquid meal increased acid secretion from 0.8 mmol H+/min to 1.48 mmol H+/min (P<0.05, pairedt test); there was an associated rise in serum levels of gastrin 120 min after feeding (P<0.001, pairedt test). Pancreatic secretion of trypsin decreased from 3.91 IU/min to 2.66 IU/min after bile diversion (P<0.01, pairedt test), and the level of CCK was significantly lower 60 min after feeding (P<0.05, pairedt test). There was no significant change in the rate of gastric emptying after bile diversion, but the pH of duodenal contents was lower in the later stages of digestion. These changes may explain the reported increase of peptic ulcer after diverting bile from the duodenum, and the procedure should not be considered unless the consequences of acid hypersecretion and pancreatic inhibition have been anticipated.

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Authors and Affiliations

  1. Department of Gastroenterology, Surgery, Biochemistry, Medical Physics and Medical Statistics, University Hospital of Wales, Heath Park, CF4 4XW, Cardiff, U.K.

    H. Alban Davies MRCP, M. H. Wheeler MD, FRCS, J. Psaila MCh, FRCS,  J. Rhodes MD, FRCP (Consultant Physician), R. G. Newcombe PhD, FSS, J. M. Jones HND, L. I. Biol, D. Procter FIMLS, T. E. Adrian PhD & S. R. Bloom MD, FRCP

  2. Welsh National School of Medicine, Cardiff, Heath Park, CF4 4XW, Cardiff, U.K.

    H. Alban Davies MRCP, M. H. Wheeler MD, FRCS, J. Psaila MCh, FRCS,  J. Rhodes MD, FRCP (Consultant Physician), R. G. Newcombe PhD, FSS, J. M. Jones HND, L. I. Biol, D. Procter FIMLS, T. E. Adrian PhD & S. R. Bloom MD, FRCP

  3. The Department of Endocrinology, Hammersmith Hospital, London, U.K.

    H. Alban Davies MRCP, M. H. Wheeler MD, FRCS, J. Psaila MCh, FRCS,  J. Rhodes MD, FRCP (Consultant Physician), R. G. Newcombe PhD, FSS, J. M. Jones HND, L. I. Biol, D. Procter FIMLS, T. E. Adrian PhD & S. R. Bloom MD, FRCP

Authors
  1. H. Alban Davies MRCP
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  2. M. H. Wheeler MD, FRCS
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  3. J. Psaila MCh, FRCS
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  4. J. Rhodes MD, FRCP
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  5. R. G. Newcombe PhD, FSS
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  6. J. M. Jones HND
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  7. L. I. Biol
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  8. D. Procter FIMLS
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  9. T. E. Adrian PhD
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  10. S. R. Bloom MD, FRCP
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Additional information

This work was supported by a grant from the Welsh Scheme for the Development of Health and Social Research.

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Alban Davies, H., Wheeler, M.H., Psaila, J. et al. Bile exclusion from the duodenum. Digest Dis Sci 30, 954–960 (1985). https://doi.org/10.1007/BF01308295

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  • DOI: https://doi.org/10.1007/BF01308295

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