Lorusso D, Misciagna G, Mangini V, Messa C, Cavallini A, Caruso M L, Giorgio P, Guerra V
Department of Surgery, Scientific Institute for Digestive Diseases S. De Bellis, Castellana Grotte Bari, Italy.
Am J Surg. 1990 Jun;159(6):575-8. doi: 10.1016/s0002-9610(06)80069-3.
In order to evaluate the effect of cholecystectomy on the gastric mucosa, the duodenogastric reflux of total and single bile acids, the number of parietal and gastrin cells, and the volume of gastric acid secretion were examined in 15 patients with gallstones and functioning gallbladders before and 6 months after cholecystectomy. The duodenogastric reflux of the total bile acids increased from a mean preoperative value of 1.9 mumol/hour to a mean postoperative value of 21 mumol/hour (p = 0.008). The duodenogastric reflux of all single bile acids increased after cholecystectomy, with a higher increase in glycoconjugated compared with tauroconjugated bile acids. The parietal cells decreased from a mean preoperative value of 82.8 to a mean postoperative value of 68.7 (p = 0.05), whereas there was only a mild increase in the number of gastrin cells; the output of gastric acid remained unchanged. The variation of the gastrin cells before and after cholecystectomy was negatively correlated only with the variation of taurocholic acid (r = -0.50, p = 0.05), while the variation of the parietal cells was mildly correlated with all single bile acids (r = 0.35-0.50, 0.05 less than p less than 0.02). These findings show an increased duodenogastric reflux of bile acids 6 months after cholecystectomy with a mild morphologic alteration of the gastric mucosa.
为了评估胆囊切除术对胃黏膜的影响，对15例有功能胆囊的胆结石患者在胆囊切除术前及术后6个月进行了总胆汁酸和单个胆汁酸的十二指肠胃反流、壁细胞和胃泌素细胞数量以及胃酸分泌量的检测。总胆汁酸的十二指肠胃反流从术前平均1.9微摩尔/小时增加到术后平均21微摩尔/小时（p = 0.008）。胆囊切除术后所有单个胆汁酸的十二指肠胃反流均增加，与牛磺结合型胆汁酸相比，糖结合型胆汁酸增加幅度更大。壁细胞数量从术前平均82.8减少到术后平均68.7（p = 0.05），而胃泌素细胞数量仅略有增加；胃酸分泌量保持不变。胆囊切除术前、后胃泌素细胞的变化仅与牛磺胆酸的变化呈负相关（r = -0.50，p = 0.05），而壁细胞的变化与所有单个胆汁酸呈轻度相关（r = 0.35 - 0.50，0.05 ＜ p ＜ 0.02）。这些结果表明，胆囊切除术后6个月胆汁酸的十二指肠胃反流增加，同时胃黏膜有轻度形态学改变。
