Rhodes J, Davies H A, Wheeler M H, Psaila J, Newcombe R G, Jones J M, Bloom S
Scand J Gastroenterol Suppl. 1984;92:221-3.
The effect of diverting bile from the duodenum in four dogs by cholecysto-jejunostomy was studied using a double-marker perfusion technique. During digestion of a liquid meal, acid secretion increased from 0.8 mmol H+/min to 1.48 mmol H+/min (p less than 0.05, paired t test); there was an associated rise in serum levels of gastrin 120 minutes after feeding (p less than 0.001, paired t test). Pancreatic secretion of trypsin decreased from 3.91 IU/min to 2.66 IU/min after bile diversion (p less than 0.01, paired t test) and the level of CCK was significantly lower 60 mins after feeding (p less than 0.05, paired t test). There was no significant change in the rate at which the liquid meal emptied from the stomach after bile diversion but the pH of duodenal contents was lower during the later stages of digestion. These changes may explain the reported increase of peptic ulcer after diverting bile from the duodenum and the procedure should not be considered unless the consequences of acid hypersecretion and pancreatic inhibition have been anticipated.
采用双标记灌注技术，对4只经胆囊空肠吻合术使胆汁不再流入十二指肠的犬进行了研究。在消化流质食物期间，胃酸分泌量从0.8 mmol H⁺/min增加至1.48 mmol H⁺/min（配对t检验，p<0.05）；喂食后120分钟，血清胃泌素水平相应升高（配对t检验，p<0.001）。胆汁改道后，胰蛋白酶的胰腺分泌量从3.91 IU/min降至2.66 IU/min（配对t检验，p<0.01），喂食后60分钟胆囊收缩素水平显著降低（配对t检验，p<0.05）。胆汁改道后，流质食物从胃排空的速率无显著变化，但在消化后期十二指肠内容物的pH值较低。这些变化可能解释了胆汁改道后消化性溃疡发病率增加的报道，除非已预见到胃酸分泌过多和胰腺抑制的后果，否则不应考虑该手术。
