Enjoji A, Ura K, Ozeki K, Tsukamoto M, Ikematsu Y, Kanematsu T
Second Department of Surgery, Nagasaki University School of Medicine, Japan.
Surg Today. 1996;26(7):489-95. doi: 10.1007/BF00311554.
The gallbladder has cyclic motor activity (CMA), which is impaired after a conventional gastrectomy. We conducted experiments to determine whether or not a pylorus-preserving gastrectomy (PPG) could maintain gallbladder CMA. Six strain gauge force transducers were implanted into the gastrointestinal tract and gallbladder of six dogs, respectively. The motor activity of the gastrointestinal tract and gallbladder was recorded as a control. PPG was then carried out. The phasic contractions of the gallbladder, which were correlated with the antral contractions in the control state, were synchronized with contractions of the pylorus after PPG. Intravenous administration of CCK-OP (40 ng/kg) induced phasic contractions of the gallbladder at 4.6 +/- 0.2 c/min in 3 of the 6 days with gastric contractions. After PPG, the gallbladder had phasic contractions (4.5 +/- 0.2 c/m), which were synchronized with the contractions of the pylorus in all dogs regardless of the contractions in the remnant stomach. These findings suggest that gallbladder CMa has a closer relationship with the CMA of the pylorus than with the remnant stomach after PPG. Thus, a preservation of the pylorus at the time of gastric surgery will help in maintaining gallbladder function and coordination with the remnant stomach.
胆囊具有周期性运动活性（CMA），传统胃切除术后该活性受损。我们进行了实验以确定保留幽门的胃切除术（PPG）是否能维持胆囊CMA。分别将六个应变片式力传感器植入六只犬的胃肠道和胆囊。记录胃肠道和胆囊的运动活性作为对照。然后实施PPG。胆囊的相性收缩在对照状态下与胃窦收缩相关，PPG后与幽门收缩同步。静脉注射CCK-OP（40 ng/kg）在6天中有3天在胃收缩时诱发胆囊相性收缩，频率为4.6±0.2次/分钟。PPG后，胆囊有相性收缩（4.5±0.2次/分钟），在所有犬中均与幽门收缩同步，而与残胃收缩无关。这些发现表明，PPG后胆囊CMA与幽门的CMA关系比与残胃更密切。因此，胃手术时保留幽门将有助于维持胆囊功能以及与残胃的协调性。
