Abstract
The aim of the present study was to elucidate the effect of gastric and duodenal transection on biliary manometry in anesthetized dogs. The basal biliary pressure and increase in pressure during saline perfusion at rates of 1.0 and 1.5 ml/min were studied in intact controls, during infusion of cholecystokinin (CCK) alone, and after gastric and duodenal transection. CCK dose-dependently lowered the basal pressure and the increase in pressure during perfusion. Gastric transection 1.5 cm proximal to the pylorus did not affect these parameters. In contrast, duodenal transection 1.0 cm distal to the pylorus significantly increased these parameters compared to all other groups. These observations suggest that the proximal duodenal transection, as performed during conventional distal gastrectomy, may contribute to the pathogenesis of postgastrectomy gallstone formation by altering motor function of the sphincter of Oddi.
Résumé
Le but de cette étude a été d’élucider, chez le chien anesthésié, les effets des sections duodénale et gastrique sur la manométrie biliaire. La pression biliaire de base et l’augmentation de cette pression ont été étudiées chez les animaux contröles pendant la perfusion de sérum physiologique à 1.0 et à 1.5 ml/min, avec une perfusion de cholécystokinine (CCK) seule et après section duodénale et gastrique. La diminution de la pression de base et l’augmentation de la pression pendant la perfusion étaient corrélées avec la dose de CCK. La section gastrique à 1.5 cm en amount du pylore n’a pas changé ces paramétres. Par contre, la transection duodénale à 1 cm en aval du pylore a augmenté de façon significative ces mêmes paramètres par rapport aux autres groupes. Ces observations suggèrent que la transection duodénale proximale, telle que l’on la pratique au cours d’une gastrectomic, contribue à la formation de lithiase après gastrectomie en modifiant la pression du sphincter d’Oddi.
Resumen
El propósito del presente estudio fue el de elucidar el efecto de la transección gástrica y duodenal sobre la manometría biliar en perros anestesiados. La presión biliar basal y el incremento en la presión durante perfusión con solución salina a una rata de 1.0 y 1.5 ml/min fueron estudiados en controles intactos, durante la infusión de colecistocinina (CCK) y luego de la transección gástrica y duodenal. La CCK, en forma de dosis-dependiente disminuyó la presión basal y el nivel de incremento de la presión durante la perfusión. La transección gástrico a 1.5 cm proximales al píloro no afectó tales parámetros. En contraste, la transección duodenal a 1 cm distal al píloro aumentó significativamente estos parámetros en comparación con los otros grupos. Estas observaciones sugieren que la transección duodenal proximal, como la que se realiza en una gastrectomía convencional, puede contribuir a la patogénesis de la formation postoperatoria de cálculos en la vesícula biliar mediante la alteración de la función motora del esfinter de Oddi.
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Shibata, C., Sasaki, I., Naito, H. et al. Duodenal but not gastric transection disturbs motility of the sphincter of Oddi in the dog. World J. Surg. 21, 191–194 (1997). https://doi.org/10.1007/s002689900214
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DOI: https://doi.org/10.1007/s002689900214