Lanzini A, Jazrawi R P, Northfield T C
Gastroenterology. 1987 Apr;92(4):852-61. doi: 10.1016/0016-5085(87)90957-7.
We have carried out simultaneous, quantitative measurements of absolute gallbladder (GB) storage and emptying in 6 subjects with gallstones, using a modified duodenal perfusion technique that incorporates technetium 99m-labeled diethyl phenylcarbamomethyl iminodiacetate (99mTc-HIDA) as a GB bile marker in addition to indocyanine green as a hepatic bile marker. The technique was validated by measuring duodenal recovery of 99mTc-HIDA (mean +/- SEM, 101% +/- 4%), and also by studying 2 subjects who had undergone cholecystectomy. During the first hour following an evening meal, cumulative GB ejection of 99mTc-HIDA in the 6 subjects with gallstones was 43% +/- 12%. This was accompanied by GB storage of most hepatic indocyanine green (70% +/- 5%) during each 10-min interval of that hour. During subsequent overnight fasting, storage of hepatic indocyanine green (89% +/- 2%) was accompanied by ejection of 99mTc-HIDA from the GB in 33 of the 66 hourly intervals. Since 'simultaneous' filling and emptying cannot occur through the cystic duct, the results suggest frequent alternations in absolute GB storage and emptying, a phenomenon more analogous to a bellows than to the conventional concept of a simple pump.
我们采用改良的十二指肠灌注技术，对6例胆结石患者的胆囊绝对储存和排空进行了同步定量测量。该技术除了使用吲哚菁绿作为肝胆汁标记物外，还采用锝99m标记的二乙苯基氨甲酰甲基亚氨基二乙酸（99mTc-HIDA）作为胆囊胆汁标记物。通过测量十二指肠对99mTc-HIDA的回收率（平均值±标准误，101%±4%）以及研究2例接受胆囊切除术的患者，对该技术进行了验证。在晚餐后的第一个小时内，6例胆结石患者胆囊中99mTc-HIDA的累积排出量为43%±12%。在此期间，每10分钟间隔内胆囊储存了大部分肝吲哚菁绿（70%±5%）。在随后的夜间禁食期间，66个小时间隔中有33个间隔胆囊排出99mTc-HIDA的同时，肝吲哚菁绿的储存率为89%±2%。由于通过胆囊管不可能同时发生“同步”充盈和排空，结果表明胆囊绝对储存和排空频繁交替，这种现象更类似于风箱，而不是传统的简单泵的概念。
