Evrard S, Aprahamian M, Hoeltzel A, Vasilescu M, Marescaux J, Damgé C
Department of Surgery A, Les Hôpitaux Universitaires de Strasbourg, France.
Int J Obes Relat Metab Disord. 1993 Sep;17(9):541-7.
Biliopancreatic bypass (BPB), the exclusion of a duodenojejunal loop from the digestive continuity, has been proposed as a bariatric procedure for treatment of morbid obesity. The present study in rats investigated the effect of this surgical procedure on the mucosae of the ileum directly anastomosed to the stomach, and of the jejunum irrigated only by biliopancreatic secretions. The proximal part of the ileum adapted by two-fold increases in its mucosal mass, total protein and RNA content; DNA content was four-fold higher than in sham-operated animals. There was a correlated increase of mucosal enzyme content, except for lactase. In the distal ileal mucosae, a slight, transient augmentation of mucosal mass, protein, DNA and RNA content was observed which tended to compensate for the shortening of the functional gut. No morphological changes were found in the excluded loop, probably because of an endoluminal stimulation by biliopancreatic secretions. Thus, in BPB, biliopancreatic secretions seem to exert trophic effects on the intestinal mucosa, but they are less potent than the endoluminal nutrition that restores the oral-aboral mucosal gradient.
胆胰转流术（BPB），即将十二指肠空肠袢排除在消化连续性之外，已被提议作为治疗病态肥胖的一种减肥手术。本研究在大鼠中探究了这种手术对直接与胃吻合的回肠黏膜以及仅由胆胰分泌物灌注的空肠黏膜的影响。回肠近端黏膜质量、总蛋白和RNA含量增加了两倍；DNA含量比假手术动物高四倍。除乳糖酶外，黏膜酶含量也相应增加。在回肠远端黏膜中，观察到黏膜质量、蛋白质、DNA和RNA含量有轻微、短暂的增加，这倾向于补偿功能性肠道的缩短。在被排除的肠袢中未发现形态学变化，可能是由于胆胰分泌物的腔内刺激。因此，在胆胰转流术中，胆胰分泌物似乎对肠黏膜发挥营养作用，但它们的作用不如恢复口-肛黏膜梯度的腔内营养有效。
