Calabuig R, Weems W A, Moody F G
Department of Surgery and Physiology, University of Texas Medical School, Houston.
Gastroenterology. 1990 Dec;99(6):1641-6. doi: 10.1016/0016-5085(90)90469-h.
The aim of this study was to test in vivo (a) whether the sphincter of Oddi acts as a resistor or also as a pump, (b) the effect of an IV infusion of cholecystokinin (CCK) on choledochoduodenal flow, and (c) the ability of the choledochoduodenal junction to prevent duodenobiliary reflux in two animal species, opossums (n = 11) and cats (n = 8). Opossums were implanted with bipolar electrodes on the sphincter of Oddi and the adjacent duodenum. Cats were not. Experiments were performed in vivo using a propulsion evaluation system to test whether the Sphincter of Oddi was able to pump fluid from the bile duct to the duodenum against pressure gradients. In 5 opossums and 4 cats, choledochoduodenal flow was evaluated during the IV infusion of CCK (20 ng.kg-1.min-1). The opossum sphincter of Oddi moved fluid against duodenal pressure gradients of 6-45 cm H2O. The spike-burst frequency (6.4 +/- 1.7 min-1) was maximal at peak bile duct pressures and decreased as bile duct pressure decreased (4.9 +/- 1.6 min-1; P less than 0.001). Pressure pulses in the bile duct were observed at a frequency that correlated with sphincter of Oddi spike-burst frequency (r = 0.84; P less than 0.001). In cats, choledochoduodenal flow occurred only along a hydrostatic gradient; the sphincter of Oddi never acted as a pump but only as a resistor. Infusion of CCk significantly increased the frequency of sphincter of Oddi contractions in opossums, but the transfer of fluid from bile duct to duodenum was significantly reduced. In cats, the rate of fluid flow from the bile duct to the duodenum during CCK infusion did not differ from control values. Reflux of duodenal fluid into the biliary tree was never observed, even at duodenal pressures as high as 100 cm H2O. In conclusion, in vivo, the sphincter of Oddi is able to pump fluid from the bile duct to the duodenum against a pressure gradient in opossums, but, in cats, choledochoduodenal flow requires a bilioduodenal pressure gradient. The increase in sphincter of Oddi contraction frequency induced by CCK in opossums resulted in a decrease in active transsphincteric flow. Duodenobiliary reflux could not be elicited in opossums and cats under the conditions of these experiments.
(a) 奥迪括约肌是起到阻力器的作用还是也起到泵的作用;(b) 静脉输注胆囊收缩素(CCK)对胆总管十二指肠流量的影响;(c) 在两种动物——负鼠(n = 11)和猫(n = 8)中,胆总管十二指肠交界处防止十二指肠胆汁反流的能力。给负鼠的奥迪括约肌和相邻十二指肠植入双极电极,猫未植入。使用推进评估系统在体内进行实验,以测试奥迪括约肌是否能够克服压力梯度将液体从胆管泵入十二指肠。在5只负鼠和4只猫中,在静脉输注CCK(20 ng·kg⁻¹·min⁻¹)期间评估胆总管十二指肠流量。负鼠的奥迪括约肌能克服6 - 45 cm H₂O的十二指肠压力梯度推动液体。在胆管压力峰值时,尖峰 - 爆发频率(6.4 ± 1.7次/分钟)最高,随着胆管压力降低而下降(4.9 ± 1.6次/分钟;P < 0.001)。观察到胆管中的压力脉冲频率与奥迪括约肌尖峰 - 爆发频率相关(r = 0.84;P < 0.001)。在猫中,胆总管十二指肠流量仅沿静水压力梯度发生;奥迪括约肌从未起到泵的作用,仅起到阻力器的作用。输注CCK显著增加了负鼠奥迪括约肌收缩的频率,但从胆管到十二指肠的液体传输显著减少。在猫中,CCK输注期间从胆管到十二指肠的液体流速与对照值无差异。即使在十二指肠压力高达100 cm H₂O时,也从未观察到十二指肠液反流至胆管树。总之,在体内,负鼠的奥迪括约肌能够克服压力梯度将液体从胆管泵入十二指肠,但在猫中,胆总管十二指肠流量需要胆管十二指肠压力梯度。CCK诱导的负鼠奥迪括约肌收缩频率增加导致主动跨括约肌流量减少。在这些实验条件下,负鼠和猫均未引发十二指肠胆汁反流。