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肠切除术对胆汁成分和肝脏超微结构的影响。

Influence of intestinal resections on biliary composition and liver ultrastructure.

机构信息

General Surgery Service of the University Hospital Complex, Badajoz, Spain.

出版信息

Clin Nutr. 2011 Apr;30(2):247-51. doi: 10.1016/j.clnu.2010.09.002. Epub 2010 Oct 12.

Abstract

BACKGROUND & AIMS: Among the multiple factors that can influence bile acid (BA) metabolism and biliary poles, intestinal resections could do so directly (through absorption alterations) and/or indirectly (bacterial translocation, alterations of the hepato-intestinal hormonal axis). Our aim was to study the influence of partial intestinal resections on bile metabolism and biliary structure in an animal model.

METHODS

Dunkin Hartley guinea pigs were used: Group A with only jejunum resection, Group B with only ileum resection, and Group CtrG, the control group. They were monitored for 21 days, with oral nutrition. At the end of this period, samples of the bile were taken from the hepatic duct and vena cava. After liver perfusion, samples of hepatic tissue were taken for optical and electron microscopy.

RESULTS

There was a significant decrease in serum cholesterol in both GA & GB. The levels of biliary phospholipids (Ph) and cholic acid decreased only in Group B, but not ketolithocholic acid nor total conjugated BA. Slight liver macrosteatosis was observed in GB, but there were no changes in the biliary poles or canaliculi in the electron microscopy samples.

CONCLUSIONS

Ileum resections affect the biliary Ph and BA composition, which could increase bile lithogenicity but do not seem to affect biliary duct anatomy.

摘要

背景与目的

在影响胆汁酸(BA)代谢和胆管极性的多种因素中,肠道切除术可直接(通过吸收改变)和/或间接(细菌易位、肝胆激素轴改变)产生影响。我们的目的是在动物模型中研究部分肠道切除术对胆汁代谢和胆管结构的影响。

方法

使用达能哈特里豚鼠:仅行空肠切除术的 A 组、仅行回肠切除术的 B 组和对照组 CtrG。术后给予口服营养,监测 21 天。在此期间结束时,从肝管和腔静脉采集胆汁样本。肝灌注后,取肝组织样本进行光学和电子显微镜检查。

结果

GA 和 GB 组的血清胆固醇水平均显著降低。仅在 B 组中,胆汁磷脂(Ph)和胆酸水平降低,但酮石胆酸和总结合胆汁酸没有降低。GB 中观察到轻微的肝大泡脂肪变性,但电子显微镜样本中胆管极性或胆小管没有变化。

结论

回肠切除术影响胆汁 Ph 和 BA 组成,可能增加胆汁成石性,但似乎不影响胆管解剖结构。

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