实验性急性胰腺炎期间结肠次全切除术对细菌移位的影响。

Effects of subtotal colectomy on bacterial translocation during experimental acute pancreatitis.

作者信息

van Minnen L Paul, Nieuwenhuijs Vincent B, de Bruijn Menno T, Verheem André, Visser Maarten R, van Dijk Jaap E, Akkermans Louis M A, Gooszen Hein G

机构信息

Department of Surgery, University Medical Center, Utrecht, The Netherlands.

出版信息

Pancreas. 2006 Jan;32(1):110-4. doi: 10.1097/01.mpa.0000191650.24796.89.

DOI:10.1097/01.mpa.0000191650.24796.89

PMID:16340752

Abstract

OBJECTIVES

The colon is considered a major source of bacteria causing infection of pancreatic necrosis in acute pancreatitis (AP). Subtotal colectomy before AP in rats reduces mortality, but its role in affecting small bowel flora, bacterial translocation, and infection of pancreatic necrosis is unknown. Our aim was to study these phenomena in rats with AP.

METHODS

Fifty rats, allocated in 4 groups, underwent 2 laparotomies: group 1, sham laparotomy and saline biliopancreatic duct infusion; group 2, subtotal colectomy and saline infusion; group 3, sham laparotomy and AP (ductal infusion of glycodeoxycholic acid and intravenous cerulein); group 4, subtotal colectomy and AP. Seventy-two hours later, samples were collected for microbiological analysis.

RESULTS

Subtotal colectomy caused small bowel bacterial overgrowth with gram-positive cocci (group 1 versus group 2, duodenum: P = 0.030, ileum: P = 0.029). Bacterial counts of gram-negative rods/anaerobes in the duodenum and ileum and pancreatic bacterial counts of rats with colectomy and AP were significantly higher than in rats with AP only (group 3 versus group 4, duodenum: P = 0.040, ileum: P = 0.029, pancreas: P = 0.017). Duodenal bacterial overgrowth and pancreatic infection correlate significantly (r = 0.45, P = 0.004).

CONCLUSIONS

Subtotal colectomy induces small bowel bacterial overgrowth, which is associated with increased bacterial translocation to the pancreas.

摘要

目的

结肠被认为是急性胰腺炎（AP）中导致胰腺坏死感染的主要细菌来源。大鼠在发生AP之前进行结肠次全切除术可降低死亡率，但其对小肠菌群、细菌移位及胰腺坏死感染的影响尚不清楚。我们的目的是在患有AP的大鼠中研究这些现象。

方法

50只大鼠分为4组，接受2次剖腹手术：第1组，假手术并向胆胰管输注生理盐水；第2组，结肠次全切除术并输注生理盐水；第3组，假手术并诱导AP（向胆管输注甘氨脱氧胆酸并静脉注射雨蛙肽）；第4组，结肠次全切除术并诱导AP。72小时后，采集样本进行微生物分析。

结果

结肠次全切除术导致小肠革兰氏阳性球菌过度生长（第1组与第2组相比，十二指肠：P = 0.030，回肠：P = 0.029）。结肠次全切除术并发生AP的大鼠十二指肠和回肠中革兰氏阴性杆菌/厌氧菌的细菌计数以及胰腺细菌计数显著高于仅发生AP的大鼠（第3组与第4组相比，十二指肠：P = 0.040，回肠：P = 0.029，胰腺：P = 0.017）。十二指肠细菌过度生长与胰腺感染显著相关（r = 0.45，P = 0.004）。