Takahashi M, Sasaki I, Naito H, Funayama Y, Shibata C, Ohtani N, Matsuno S
First Department of Surgery, Tohoku University School of Medicine, 1-1, Seiryoumachi, Aoba-ku, Sendai 980-8574, Japan.
J Gastrointest Surg. 2000 Sep-Oct;4(5):513-9. doi: 10.1016/s1091-255x(00)80094-3.
The aim of this study was to elucidate the mechanism of chronic biliary diversion and its effect on pancreatic growth. In the first part of the study, nine mongrel dogs underwent diversion of bile from the gastrointestinal tract by ligating the common bile duct and interposing a segment of jejunum between the gallbladder and the urinary bladder (cholecystojejunocystostomy [CJC]). Despite the loss of 7% of their body weight at 12 weeks after bilioenteric diversion, CJC dogs had significantly greater pancreatic wet weight than control dogs (51.2 +/- 2.2 g vs. 37.1 +/- 2.2 g). In the second part of the study, six other dogs underwent CJC. Twelve weeks later, bilioenteric continuity was restored by creating a cholecystojejunoduodenostomy (CJD). The dogs were given butter (3 g/kg) by mouth (prior to surgery, 12 weeks after CJC, and 4 weeks after CJD). Pancreatic excisional biopsy specimens were obtained at each operation and at autopsy. CJC induced more pancreatic RNA per milligram of weight (743 +/- 52, CJC; 579 +/- 44, prior to surgery, P <0.05 vs. CJC; 520 +/- 26 microg/100 mg tissue, CJD, P <0.01 vs. CJC), but not more DNA, and significantly higher basal plasma cholecystokinin levels and butter-stimulated cholecystokinin responses when compared with values prior to surgery or following CJD. We conclude that chronic biliary diversion induces pancreatic growth associated with hypersecretion of cholecystokinin in dogs.
本研究的目的是阐明慢性胆汁转流的机制及其对胰腺生长的影响。在研究的第一部分,9只杂种犬通过结扎胆总管并在胆囊与膀胱之间置入一段空肠(胆囊空肠膀胱吻合术[CJC]),使胆汁从胃肠道转流。尽管在胆肠转流术后12周体重减轻了7%,但CJC犬的胰腺湿重显著高于对照犬(51.2±2.2克对37.1±2.2克)。在研究的第二部分,另外6只犬接受了CJC手术。12周后,通过建立胆囊空肠十二指肠吻合术(CJD)恢复胆肠连续性。在手术前、CJC术后12周和CJD术后4周经口给予犬黄油(3克/千克)。在每次手术时及尸检时获取胰腺切除活检标本。CJC使每毫克胰腺重量的RNA增加(CJC组为743±52;手术前为579±44,与CJC组相比P<0.05;CJD组为520±26微克/100毫克组织,与CJC组相比P<0.01),但DNA未增加,并且与手术前或CJD术后的值相比,基础血浆胆囊收缩素水平和黄油刺激的胆囊收缩素反应显著更高。我们得出结论,慢性胆汁转流可诱导犬胰腺生长,并伴有胆囊收缩素分泌过多。