[Effects of reflux of bile and/or pancreaticoduodenal juice on gastric carcinogenesis in rats].

The present study was designed to investigate which fraction of duodenal contents was responsible for gastric carcinogenesis, bile or pancreaticoduodenal juice. A series of 61 male Wistar rats were subjected to one of following four operative procedures: total reflux (TR, n = 17), bile reflux (BR, n = 8), or pancreaticoduodenal reflux (PDR, n = 16), and simple laparotomy (control, n = 20). Fifty weeks after operations the animals were sacrificed. The incidence of gastric adenocarcinoma was 7/17 (41%) in TR group, 2/8 (25%) in BR group, 0/16 (0%) in PDR group, and 0/20 (0%) in control group. The incidence of cancer in the both TR and BR groups were significantly higher than PDR and control groups, respectively. Histologically, lesions of gastric cancers showed tubular adenocarcinoma or mucinous adenocarcinoma. There was a significant difference in the intragastric pH between the first three reflux groups and control group. The concentrations of the total bile acids of the both TR and BR groups were significantly higher than PDR and control groups, respectively. These results suggested that duodenogastric reflux induces adenocarcinoma in the rat gastric mucosa and bile rather than pancreatico-duodenal juice is related to increased risk for gastric cancer.