Tanaka M, Sarr M G
J Surg Res. 1987 May;42(5):483-93. doi: 10.1016/0022-4804(87)90022-9.
Motor activity of the upper gastrointestinal tract undergoes a cyclic pattern during fasting called the migrating motor complex (MMC). The role of the duodenum in controlling this cyclic activity was studied in the dog. Five dogs served as controls. In four other dogs, the entire duodenum and the proximal 20 cm of jejunum were resected. The ostia of the bile duct and pancreatic duct were preserved as "mucosal buttons" and reimplanted in situ into the jejunum after gastrojejunostomy. All dogs had manometry catheters placed into the stomach and serosal electrodes implanted onto the small intestine to monitor gastrointestinal motility. All control dogs showed the characteristic MMC in the stomach and small intestine, the period being 112 +/- 16 min (mean +/- SEM). After total duodenectomy, an irregular, noncyclic pattern of contractions occurred in the stomach in two of the four dogs during fasting. The other two dogs had a cyclic pattern of gastric motility; however, the overall characteristics of these cyclic patterns of gastric motility differed from that of controls. A variable proportion of the phases of cyclic gastric activity did not fit the criterion for temporal coordination with the jejunum as defined from study of control dogs. In contrast, jejunal motility in all four dogs after total duodenectomy continued to exhibit the characteristic MMC, but the period of the cycle (58 +/- 7 min) was shorter than in controls (P less than 0.05). "Ectopic" jejunal activity fronts with no preceding gastric contractions were frequent. After total duodenectomy, plasma concentration of motilin remained lower than normal and showed no cyclic variation with the jejunal MMC. After total duodenectomy, feeding interrupted the fasting motor pattern of the stomach as in controls, but did not disrupt the MMC in the jejunum. We concluded that the duodenum has an important role in initiating cyclic gastric motor activity and in coordinating motor activity between the stomach and the small intestine.
在禁食期间，上消化道的运动活动呈现出一种周期性模式，称为移行性运动复合波（MMC）。在狗身上研究了十二指肠在控制这种周期性活动中的作用。五只狗作为对照。另外四只狗切除了整个十二指肠和空肠近端20厘米。胆管和胰管的开口被保留为“黏膜纽扣”，并在胃空肠吻合术后原位重新植入空肠。所有的狗都将测压导管插入胃中，并将浆膜电极植入小肠以监测胃肠动力。所有对照狗的胃和小肠都显示出特征性的MMC，周期为112±16分钟（平均值±标准误）。全十二指肠切除术后，四只狗中的两只在禁食期间胃出现不规则、非周期性的收缩模式。另外两只狗有周期性的胃动力模式；然而，这些周期性胃动力模式的总体特征与对照不同。周期性胃活动的不同阶段与空肠的时间协调不符合根据对照狗研究定义的标准。相比之下，全十二指肠切除术后所有四只狗的空肠动力继续表现出特征性的MMC，但周期（58±7分钟）比对照狗短（P<0.05）。没有先前胃收缩的“异位”空肠活动前沿很常见。全十二指肠切除术后，胃动素的血浆浓度仍低于正常水平，且与空肠MMC无周期性变化。全十二指肠切除术后，进食像对照狗一样中断了胃的禁食运动模式，但没有破坏空肠中的MMC。我们得出结论，十二指肠在启动周期性胃运动活动以及协调胃和小肠之间的运动活动中起重要作用。
