Gélinas M D, Morin C L
Can J Physiol Pharmacol. 1980 Sep;58(9):1117-23. doi: 10.1139/y80-167.
After proximal small bowel resection the remaining small intestine undergoes adaptive hyperplasia. In the present study, the relative contributions of bile and (or) pancreatic juice to adaptive intestinal hyperplasia following proximal resection was studied. Using male Sprague-Dawley rats a 50% proximal intestinal resection was done starting 10 cm distal to the beginning of the jejunum. The animals were also subjected to diversion of bile and (or) pancreatic secretions to the distal ileum at 18 cm proximal to the ileocecal junction. After 8 days gut and mucosal weights, mucosal proteins, and DNA were measured in the duodenojejunum (gut segment proximal to the resection anastomosis) and in the ileum (first half of the small bowel segment distal to the diversion site). The results indicate that (1) in rats fed either chow (Purina rat chow) or a chemically defined diet diversion of pancreaticobiliary secretions to the ileum significantly stimulated ileal mucosa growth whereas no changes were observed in the duodenojejunum, (2) in rats fed a chemically defined diet neither bile nor pancreatic juice affected ileal mucosa when separately diverted to the ileum, and (3) pancreatic juice draining into the duodenum while bile was diverted to the ileum induced hypoplastic changes in the duodenojejunum. The present study suggests that following jejunectomy the regulation of mucosal growth by pancreatic and bile secretions is different in the proximal and distal small intestine. Pancreaticobiliary secretions are trophic for the ileum. However, in the proximal gut bile offers protection against a direct or indirect catabolic action of pancreatic juice.
近端小肠切除术后,剩余的小肠会发生适应性增生。在本研究中,探讨了胆汁和(或)胰液对近端切除术后小肠适应性增生的相对作用。采用雄性Sprague-Dawley大鼠,从空肠起始部远端10 cm处进行50%的近端小肠切除术。这些动物还接受了将胆汁和(或)胰液引流至回盲部近端18 cm处的远端回肠的操作。8天后,测量十二指肠空肠段(切除吻合口近端的肠段)和回肠(引流部位远端小肠段的前半部分)的肠重和黏膜重量、黏膜蛋白及DNA。结果表明:(1)在喂食普瑞纳大鼠饲料或化学限定饮食的大鼠中,将胰胆分泌液引流至回肠可显著刺激回肠黏膜生长,而十二指肠空肠段未观察到变化;(2)在喂食化学限定饮食的大鼠中,单独将胆汁或胰液引流至回肠时,两者均不影响回肠黏膜;(3)当胆汁引流至回肠而胰液流入十二指肠时,十二指肠空肠段会出现发育不全的变化。本研究提示,空肠切除术后,胰液和胆汁分泌对近端和远端小肠黏膜生长的调节作用不同。胰胆分泌液对回肠具有营养作用。然而,在近端肠道,胆汁可保护肠道免受胰液直接或间接的分解代谢作用。