Malfertheiner P, Büchler M, Glasbrenner B, Schafmayer A, Ditschuneit H
Department of Internal Medicine and Gastroenterology, University of Ulm, FRG.
Digestion. 1987;38(3):142-51. doi: 10.1159/000199583.
This study was performed to investigate adaptive changes of the exocrine pancreas occurring after distal gastric resection by different procedures: Billroth I (BI) and Billroth II (BII). Sixty-four male Wistar rats were used and divided into four groups: controls (n = 16), sham-operated (n = 16), BI (n = 16) and BII (n = 16) subtotal gastric resection. Both procedures of subtotal gastric resection showed an organotrophic effect on the pancreas after 2 weeks: pancreatic weight in BI- and BII-operated rats increased by 23 and 35% and DNA content by 36 and 27%, respectively, compared to controls (p less than 0.001). After 4 weeks a further increase in pancreatic weight (46%), DNA content (52%) and protein content (58%) was found in BII rats. Trypsin and amylase content were increased in BI rats after 2 weeks (p less than 0.01). No parallel changes were observed in the enzyme content of BII rats as trypsin increased by over 200%, amylase by over 100% and lipase remained unaffected. Hormonal studies were carried out in 36 rats divided into groups as above. Basal and stimulated plasma levels of gastrin were reduced (p less than 0.01) following both types of subtotal gastric resection (p less than 0.01). Basal cholecystokinin (CCK) plasma levels did not differ between operated and control rats. Following the test meal CCK plasma levels were significantly increased after BII gastric resection (p less than 0.001) and BI gastric resection (p less than 0.01) compared to controls.
本研究旨在探讨不同手术方式(毕Ⅰ式(BI)和毕Ⅱ式(BII))远端胃切除术后外分泌胰腺的适应性变化。选用64只雄性Wistar大鼠,分为四组:对照组(n = 16)、假手术组(n = 16)、BI胃大部切除术组(n = 16)和BII胃大部切除术组(n = 16)。两种胃大部切除手术在术后2周均对胰腺显示出器官营养作用:与对照组相比,BI手术组和BII手术组大鼠的胰腺重量分别增加了23%和35%,DNA含量分别增加了36%和27%(p < 0.001)。4周后,BII组大鼠的胰腺重量(增加46%)、DNA含量(增加52%)和蛋白质含量(增加58%)进一步升高。BI组大鼠术后2周胰蛋白酶和淀粉酶含量增加(p < 0.01)。BII组大鼠的酶含量未出现平行变化,胰蛋白酶增加超过200%,淀粉酶增加超过100%,脂肪酶未受影响。对36只按上述分组的大鼠进行了激素研究。两种类型的胃大部切除术后,基础和刺激后的胃泌素血浆水平均降低(p < 0.01)。手术大鼠和对照大鼠的基础胆囊收缩素(CCK)血浆水平无差异。与对照组相比,试验餐后BII胃切除术后CCK血浆水平显著升高(p < 0.001),BI胃切除术后也显著升高(p < 0.01)。