Doty J E, Pitt H A, Porter-Fink V, Denbesten L
Ann Surg. 1985 Jan;201(1):76-80.
Recent studies indicate that long-term total parenteral nutrition (TPN) induces gallstone formation and acalculous cholecystitis in humans. Cholecystectomy is hazardous for these patients because they frequently have multiple medical problems and have undergone numerous abdominal operations. The present study was designed to develop a method to prevent TPN-induced gallbladder disease. The authors tested the hypothesis that a single daily intravenous infusion of cholecystokinin-octapeptide (CCK-OP) will prevent TPN-induced gallbladder stasis. Eleven prairie dogs received TPN for 10 days. Six of these animals were given a daily infusion of CCK-OP. Control animals were fed ad lib. Each animal's bile salt pool was labeled with intravenous 3H-cholic acid 16 hours prior to acute terminal experiments. The ratio of gallbladder to hepatic bile 3H-cholic acid specific activity (Rsa) provides an index of gallbladder stasis. A Rsa of less than 1.0 indicates gallbladder stasis. TPN animals had a Rsa of 0.54 +/- 0.13 (p less than 0.01 vs. controls), indicating stasis of bile in the gallbladder. Daily CCK-OP infusions resulted in a Rsa of 0.92 +/- 0.10 (p less than 0.05 vs. TPN without CCK-OP), indicating that TPN-induced gallbladder stasis is prevented by daily CCK-OP. Control animals had a Rsa of 1.03 +/- 0.06. The cholesterol saturation indices of gallbladder and hepatic bile were not increased by TPN or CCK-OP. These data indicate that 1) TPN induces gallbladder stasis but does not increase bile lithogenic index; and 2) daily injections of CCK-OP prevent TPN-induced gallbladder stasis.
近期研究表明，长期全胃肠外营养（TPN）可导致人类胆结石形成及无结石性胆囊炎。胆囊切除术对这些患者具有危险性，因为他们常有多种内科疾病且已接受过多次腹部手术。本研究旨在开发一种预防TPN所致胆囊疾病的方法。作者检验了如下假设：每日单次静脉输注胆囊收缩素八肽（CCK-OP）可预防TPN所致胆囊淤滞。11只草原犬接受TPN 10天。其中6只动物每日输注CCK-OP。对照动物自由进食。在急性终末实验前16小时，每只动物的胆盐池用静脉注射的3H-胆酸进行标记。胆囊胆汁与肝胆汁3H-胆酸比活性（Rsa）可作为胆囊淤滞的指标。Rsa小于1.0表明存在胆囊淤滞。接受TPN的动物Rsa为0.54±0.13（与对照组相比，p<0.01），表明胆囊胆汁淤滞。每日输注CCK-OP导致Rsa为0.92±0.10（与未用CCK-OP的TPN组相比，p<0.05），表明每日输注CCK-OP可预防TPN所致胆囊淤滞。对照动物的Rsa为1.03±0.06。TPN或CCK-OP未使胆囊胆汁和肝胆汁的胆固醇饱和指数升高。这些数据表明：1）TPN可导致胆囊淤滞，但不增加胆汁成石指数；2）每日注射CCK-OP可预防TPN所致胆囊淤滞。
