肝移植受者中去神经支配供体胆囊的正常空腹容量和餐后排空情况。

Normal fasting volume and postprandial emptying of the denervated donor gallbladder in liver transplant recipients.

作者信息

Vezina W C, McAlister V C, Wall W J, Engel C J, Grant D R, Ghent C N, Hutton L C, King M E, Chey W Y

机构信息

Department of Nuclear Medicine, University Hospital, London, Ontario, Canada.

出版信息

Gastroenterology. 1994 Sep;107(3):847-53. doi: 10.1016/0016-5085(94)90135-x.

DOI:10.1016/0016-5085(94)90135-x

PMID:8076771

Abstract

BACKGROUND/AIMS: Truncal vagotomy causes gallbladder dilatation and possibly cholelithiasis. During liver transplantation, when the gallbladder is transplanted with the donor liver, the gallbladder and liver are extrinsically denervated. The aim of this study was to determine whether extrinsic denervation affects gallbladder volume and postprandial emptying.

METHODS

To evaluate fasting gallbladder volume, 26 transplant recipients underwent ultrasonography. Twenty-eight normal volunteers were controls. To evaluate postprandial contractility, seven transplant recipients underwent radionuclide gallbladder-emptying studies. Gastric emptying and cholecystokinin release were simultaneously determined after a fatty meal to exclude a difference in gallbladder stimulus. Sixteen normal volunteers were controls.

RESULTS

There were no differences in fasting gallbladder volume or postprandial contractility, gastric emptying, and cholecystokinin release between transplant patients and controls. Median fasting and postprandial gallbladder volumes for the transplant recipients (95% confidence) were 16 mL (12-34 mL) and 3 mL (0-8 mL), respectively, and for controls were 18 mL (13-21 mL; P = 0.73) and 3 mL (1-6 mL; P = 0.97), respectively.

CONCLUSIONS

These data do not show gallbladder dilatation or impaired postprandial gallbladder contraction in the extrinsically denervated gallbladder. This finding suggests that gallbladder dilatation may be caused by the unopposed activity of the sympathetic system after truncal vagotomy.

摘要

背景/目的：迷走神经干切断术可导致胆囊扩张并可能引发胆石症。在肝移植过程中，当胆囊与供体肝脏一同移植时，胆囊和肝脏会发生外在去神经支配。本研究的目的是确定外在去神经支配是否会影响胆囊容积和餐后排空。

方法

为评估空腹胆囊容积，26例移植受者接受了超声检查。28名正常志愿者作为对照。为评估餐后收缩性，7例移植受者接受了放射性核素胆囊排空研究。在进食脂肪餐后同时测定胃排空和胆囊收缩素释放，以排除胆囊刺激方面的差异。16名正常志愿者作为对照。

结果

移植患者与对照组在空腹胆囊容积、餐后收缩性、胃排空和胆囊收缩素释放方面均无差异。移植受者空腹和餐后胆囊容积的中位数（95%置信区间）分别为16 mL（12 - 34 mL）和3 mL（0 - 8 mL），对照组分别为18 mL（13 - 21 mL；P = 0.73）和3 mL（1 - 6 mL；P = 0.97）。