Oishi A J, Sarr M G
Gastroenterology Research Unit, Mayo Clinic, Rochester, MN 55905, USA.
Surgery. 1995 May;117(5):545-53. doi: 10.1016/s0039-6060(05)80254-5.
The effects of small intestine transplantation on enteric physiology are poorly understood. After orthotopic jejunoileal autotransplantation, dogs develop a severe watery diarrhea and lose up to 15% of their body weight. The cause of these changes has not been explained. Our aim was to determine the influence of jejunoileal autotransplantation on ileal absorption of water, electrolytes, and bile salts and the effects of proabsorptive and prosecretory agents on ileal transport.
Seven dogs were studied before and at 2 and 8 weeks after in situ jejunoileal neural and lymphatic isolation (a model of small intestine autotransplantation). With a triple-lumen perfusion technique, net ileal fluxes of water, electrolytes, and bile salts were measured before and at 2 and 8 weeks after this model of jejunoileal autotransplantation. In addition, the effects of an intravenous infusion of vasoactive intestinal polypeptide (a prosecretory agent) and norepinephrine (a proabsorptive agent) on net transport were evaluated.
Dogs developed a profuse diarrhea after this model of autotransplantation. Ileal absorption of water and electrolytes decreased immediately (measured during operation), remained decreased for 2 weeks, and returned toward baseline by 8 weeks. A similar decrease in net flux of bile salts was shown at 2 weeks after transplantation and returned toward baseline by 8 weeks. The prosecretory response of vasoactive intestinal polypeptide on ileal fluxes of water and electrolytes was unchanged, whereas the proabsorptive response to norepinephrine increased after this model of autotransplantation.
Jejunoileal autotransplantation decreases ileal absorption of water, electrolytes, and bile salts. The profuse watery diarrhea observed in dogs after small intestine autotransplantation may be a secretory and/or a bile salt-induced diarrhea related to the effects of jejunoileal denervation.
小肠移植对肠道生理的影响了解甚少。原位空肠回肠自体移植后，犬会出现严重的水样腹泻，体重减轻多达15%。这些变化的原因尚未得到解释。我们的目的是确定空肠回肠自体移植对回肠水、电解质和胆盐吸收的影响，以及促吸收和促分泌剂对回肠转运的作用。
对7只犬在原位空肠回肠神经和淋巴管分离（小肠自体移植模型）前、术后2周和8周进行研究。采用三腔灌注技术，在空肠回肠自体移植模型前、术后2周和8周测量回肠水、电解质和胆盐的净通量。此外，评估静脉输注血管活性肠肽（一种促分泌剂）和去甲肾上腺素（一种促吸收剂）对净转运的影响。
在该自体移植模型后，犬出现大量腹泻。回肠水和电解质的吸收立即减少（手术期间测量），持续减少2周，并在8周时恢复至基线水平。移植后2周胆盐净通量也出现类似下降，并在8周时恢复至基线水平。血管活性肠肽对回肠水和电解质通量的促分泌反应未改变，而在该自体移植模型后，对去甲肾上腺素的促吸收反应增强。
空肠回肠自体移植会降低回肠对水、电解质和胆盐的吸收。小肠自体移植后犬出现的大量水样腹泻可能是与空肠回肠去神经作用相关的分泌性和/或胆盐诱导性腹泻。
