Kojima H, Kondo K, Takagi H
Department of Gastroenterological Surgery, Aichi Cancer Hospital, Nagoya, Japan.
Nihon Geka Gakkai Zasshi. 1990 Jul;91(7):818-26.
The effect of reflux of the duodenal contents on the development of gastric stump carcinoma without carcinogen in rats was studied. At the first experiment, seventy male Wistar rats were subjected to gastrojejunostomy for the diversion of duodenal contents into the resected stomach through the afferent and the efferent loops. The incidence of adenocarcinoma in the afferent anastomosis were 0/8 (0%) at the 10th week, 3/16 (18.8%) at the 20th week and 7/20 (35%) at the 40th week, so the incidence was apt to rise in parallel to the time. In the second experiment, ninety rats were divided into 4 groups: Group I received the same operation as the first experiment, group II received the operation with Braun's anastomosis, group III received the operation for reflux of bile alone to the remnant stomach, and group IV received the operation for reflux of pancreatic juice alone. Animals surviving after surgery were sacrificed at the 40th week. The incidence were 33.3% in group I, 0% in group II, 0% in group III, and 8.3% in group IV, respectively. These findings suggest that reflux of duodenal contents (both bile and pancreatic juice) is an important factor in the gastric stump carcinogenesis.
研究了十二指肠内容物反流对无致癌物作用下大鼠胃残端癌发生发展的影响。在第一个实验中，70只雄性Wistar大鼠接受了胃空肠吻合术，以使十二指肠内容物通过输入袢和输出袢进入切除后的胃。输入袢吻合口处腺癌的发生率在第10周时为0/8（0%），第20周时为3/16（18.8%），第40周时为7/20（35%），因此发生率倾向于随时间平行上升。在第二个实验中，90只大鼠被分为4组：第一组接受与第一个实验相同的手术，第二组接受带有布朗吻合术的手术，第三组接受仅将胆汁反流至残胃的手术，第四组接受仅将胰液反流的手术。术后存活的动物在第40周时被处死。各组的发生率分别为：第一组33.3%，第二组0%，第三组0%，第四组8.3%。这些发现表明十二指肠内容物（胆汁和胰液）的反流是胃残端致癌的一个重要因素。
