Pellegrini C A, Lewin M, Patti M G, Thomas M J, Ryan T, Way L W
Surgery. 1985 Sep;98(3):452-8.
We studied the effects of vagotomy on gallbladder (GB) motility in prairie dogs and humans with infusion cholescintigraphy. Twelve male prairie dogs were anesthetized and given an intravenous infusion of 120 microCi of diethyl-HIDA for 150 minutes. Images were acquired every 10 minutes. Then cholecystokinin (CCK)-8, 1.5 micrograms/kg, was given as a bolus, and images were acquired for another 30 minutes. We repeated the studies giving 300 micrograms/kg of atropine 20 minutes before administration of CCK-8. All animals underwent truncal vagotomy, and the studies were repeated 1 and 3 months later. The GB filled in a stepwise fashion; partitioning of bile varied from one 10-minute period to the next and averaged 20% +/- 2%/80% +/- 3% during the 150-minute period. Episodic partial GB emptying (ejection fraction 19% +/- 2%; intervals of 70 +/- 5 minutes) occurred during this phase. GB filling and partitioning of bile were unchanged after vagotomy. GB ejection fraction in response to CCK-8 was 69% +/- 6% in controls, 74% +/- 5% after atropine, 78% +/- 8% 4 weeks after vagotomy, and 66% +/- 6% 3 months after vagotomy. Sixteen human subjects were studied after parietal cell vagotomy (six patients) or truncal vagotomy and drainage (10 patients). GB filling average 2.5% +/- 2% per minute in patients who underwent truncal vagotomy and 3% +/- 1% per minute in patients who underwent parietal cell vagotomy. GB emptying in response to CCK-33 (0.02 U/kg/min) was 74% +/- 7% in patients who underwent truncal vagotomy and 82% +/- 4% in patients who underwent parietal cell vagotomy. Thus neither GB filling nor GB emptying in response to CCK was altered by cholinergic blockade or vagotomy.
我们通过注入式胆囊闪烁扫描术研究了迷走神经切断术对草原犬鼠和人类胆囊(GB)运动的影响。12只雄性草原犬鼠接受麻醉,并静脉输注120微居里的二乙基亚氨基二乙酸(diethyl-HIDA),持续150分钟。每10分钟采集一次图像。然后静脉推注1.5微克/千克的胆囊收缩素(CCK)-8,并再采集30分钟的图像。在注射CCK-8前20分钟,我们重复上述研究,给予300微克/千克的阿托品。所有动物均接受了躯干迷走神经切断术,并在术后1个月和3个月重复进行研究。胆囊以逐步方式充盈;胆汁的分配在不同的10分钟时间段有所不同,在150分钟期间平均为20%±2%/80%±3%。在此阶段会出现间歇性的胆囊部分排空(射血分数为19%±2%;间隔时间为70±5分钟)。迷走神经切断术后,胆囊充盈和胆汁分配没有变化。对照组中,胆囊对CCK-8的射血分数为69%±6%,阿托品处理后为74%±5%,迷走神经切断术后4周为78%±8%,术后3个月为66%±6%。对16名人类受试者进行了研究,其中6例为壁细胞迷走神经切断术患者,10例为躯干迷走神经切断术加引流术患者。接受躯干迷走神经切断术的患者胆囊充盈平均每分钟2.5%±2%,接受壁细胞迷走神经切断术患者为3%±1%。接受躯干迷走神经切断术的患者胆囊对CCK-33(0.02单位/千克/分钟)的排空率为74%±7%,接受壁细胞迷走神经切断术的患者为82%±4%。因此,无论是胆囊充盈还是胆囊对CCK的排空,都不会因胆碱能阻断或迷走神经切断术而改变。