Maselli M A, Pezzolla F, Piepoli A L, Caruso M L, Lorusso D
Laboratory of Experimental Physiopathology, Istituto Scientifico Gastroenterologico S. De Bellis, Castellana Grotte (Ba), Italy.
Neurogastroenterol Motil. 1996 Mar;8(1):29-33. doi: 10.1111/j.1365-2982.1996.tb00239.x.
Gastric surgery induces an increased incidence of gallstones. To investigate the changes in gallbladder kinetics after gastric resection, 20 male patients were studied: ten patients undergoing cholecystectomy for gallstones developed after Billroth II gastric resection and ten patients undergoing cholecystectomy for cholelithiasis without previous abdominal surgery. Longitudinal strips from the gallbladder wall were suspended in an organ bath and the isometric tension recorded. Dose-response curves to cholecystokinin-octapeptide and carbachol were obtained. Half the maximal response to cholecysto-kinin-octapeptide was 0.50 +/- 0.11 x 10(-7) M in the first group and 1.36 +/- 0.37 x 10(-7) M in the second group (P < 0.05). The ED50 to carbachol was 24.33 +/- 2.69 x 10(-7) M in the gastrectomy group and 40.39 +/- 5.01 x 10(-7) M in the control group (P < 0.01). There was no significant difference in the maximal contractile response either to cholecystokinin-octa-peptide or carbachol in the two groups. Our study shows an increased gallbladder sensitivity to cholecystokinin-octapeptide and carbachol in patients with gallstones developed after Billroth II gastric resection.
胃部手术会导致胆结石发病率增加。为了研究胃切除术后胆囊动力学的变化,对20名男性患者进行了研究:10名因毕罗Ⅱ式胃切除术后出现胆结石而接受胆囊切除术的患者,以及10名因胆石症而接受胆囊切除术且之前未接受过腹部手术的患者。将胆囊壁的纵向条带悬于器官浴槽中并记录等长张力。获得了对胆囊收缩素八肽和卡巴胆碱的剂量 - 反应曲线。第一组对胆囊收缩素八肽的半数最大反应为0.50±0.11×10⁻⁷ M,第二组为1.36±0.37×10⁻⁷ M(P<0.05)。胃切除组对卡巴胆碱的半数有效量(ED50)为24.33±2.69×10⁻⁷ M,对照组为40.39±5.01×10⁻⁷ M(P<0.01)。两组对胆囊收缩素八肽或卡巴胆碱的最大收缩反应均无显著差异。我们的研究表明,毕罗Ⅱ式胃切除术后出现胆结石的患者,其胆囊对胆囊收缩素八肽和卡巴胆碱的敏感性增加。