Journal of Hepato-Biliary-Pancreatic Surgery

, Volume 2, Issue 3, pp 273–278 | Cite as

Bile acid inhibits tetragastrin-stimulated gastric secretion after Roux-en-Y biliary diversion in dogs

  • Hideaki Shimogama
  • Toshifumi Eto
  • Takashi Kanematsu
Original Article
  • 24 Downloads

Abstract

The present study was carried out to investigate the effect of several bile acids on tetragastrin-stimulated gastric secretion in dogs in which diversion of the biliary system was performed. Cholecystojejunostomy of the Roux-en-Y type was performed, along with the creation of a Heidenhain pouch (HP) and an external duodenal fistula. Gastric juice was collected from the HP and a mixture of bile acids and corn oil was administered through the duodenal fistula. Ursodeoxycholic acid (UDCA) and chenodeoxycholic acid (CDCA) exerted an inhibitory effect on gastric hypersecretion. Conjugated UDCA and several bile acids with different hydroxyl groups were also examined, and these bile acids also showed evidence of an inhibitory effect on the secretion of gastric juice, although there were no significant differences between them. Thus, it appears that all bile acids inhibit tetragastrin-stimulated gastric hypersecretion. This finding suggests that peptic ulcer disease can be prevented by the administration of bile acids to patients who undergo biliary diversion and are at a high risk for this postoperative complication.

Key words

bile acids gastric hypersecretion biliary diversion 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    McArthur MS, Longmire WP (1971) Peptic ulcer disease after choledochojejunostomy. Am J Surg 122:155–158CrossRefPubMedGoogle Scholar
  2. 2.
    Nielsen ML, Jensen SL, Malmstrøm J, Nielsen OV (1980) Gastrin and gastric acid secretion in hepaticojejunostomy Rouxen-Y. Surg Gynecol Obstet 150:61–64PubMedGoogle Scholar
  3. 3.
    Imamura M, Kameyama J, Ohneda A, Sato T (1982) Effect of various reconstructions of the biliary tract upon the secretion of gastric acid and gastrointestinal hormones in dogs. Surg Gastroenterol 1:105–114Google Scholar
  4. 4.
    Eto T, Tompkins RK (1985) Inhibition of pepsin activity by ursodeoxycholic acids and chenodeoxycholic acids. Am J Surg 150:564–567CrossRefPubMedGoogle Scholar
  5. 5.
    Eto T, Tompkins RK (1986) Further studies on the inhibition of pepsin by bile salts. Ann Surg 203:8–12PubMedGoogle Scholar
  6. 6.
    Tatsumi M, Ishikawa Y, Ito N (1982) The effect of biliary diversion on the inhibition of gastric secretion by fat in dogs (in Japanese with English abstract). Nippon Syokakibyo Gakkai Zasshi (Jpn J Gastroenterol) 79:1694–1700Google Scholar
  7. 7.
    Martin EW, O'Dorisio TM, Spaeth J, Thomford NR, Cataland S (1980) The association between endogenous gastric inhibitory polypeptide release and suppression of gastric acid output following intraduodenal fat stimulation. J Surg Res 29:71–74CrossRefPubMedGoogle Scholar
  8. 8.
    Johnson LR, Grossman MI (1969) Characteristics of inhibition of gastric secretion by secretin. Am J Physiol 217:1401–1404PubMedGoogle Scholar
  9. 9.
    Carey MC, Small DM (1972) Micelle formation by bile salts. Physical-chemical and thermodynamic considerations. Arch Intern Med 130:506–527PubMedGoogle Scholar
  10. 10.
    Wormsley KG (1970) Stimulation of pancreatic secretion by intraduodenal infusion of bile salts. Lancet II:586–588Google Scholar
  11. 11.
    Konturek SJ, Thor P (1973) Effect of diversion and replacement of bile on pancreatic secretion. Am J Dig Dis 18:971–977PubMedGoogle Scholar
  12. 12.
    Fordtran JS, Locklear TW (1966) Ionic constituents and osmolarity of gastric and small intestinal fluids after eating. Am J Dig Dis 11:503–521CrossRefPubMedGoogle Scholar
  13. 13.
    Nakamura T (1979) The changes of bile acid composition in the patients with chronic pancreatitis. Gastroenterol Jpn 14:114–121PubMedGoogle Scholar
  14. 14.
    Bachrach WH, Hofmann AF (1982) Ursodeoxycholic acid in the treatment of cholesterol cholelithiasis. Dig Dis Sci 27:737–761PubMedGoogle Scholar
  15. 15.
    Lillemoe KD, Kidder GW, Harmon JW, Gadacz TR, Johnson LF, Bunte RM, Hofmann AF (1983) Tauroursodeoxycholic acid is less damaging than taurochenodeoxycholic acid to the gastric and esophageal mucosa. Dig Dis Sci 28:359–364CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • Hideaki Shimogama
    • 1
  • Toshifumi Eto
    • 1
  • Takashi Kanematsu
    • 1
  1. 1.Second Department of SurgeryNagasaki University School of MedicineNagasakiJapan

Personalised recommendations