Shibata C, Sasaki I, Naito H, Matsuno S
First Department of Surgery, Tohoku University School of Medicine, Sendai, Japan.
Lab Anim Sci. 1996 Aug;46(4):438-41.
An aim of this study was to establish a simple method for the construction of a Pavlov pouch that is free of fistula formation between the main part of the stomach and the pouch, yet preserves maximal vagal innervation. The Pavlov pouch (vagally innervated gastric pouch) was constructed from the greater curvature of the gastric corpus at the level of the splenic hilus in four dogs. The plane between the mucosal and seromuscular layers was dissected bluntly along the medial margin of the pouch. A surgical stapler was introduced into the space between the mucosal and seromuscular layers, and the pouch was completely separated from the main part of the stomach enterically at the mucosal level but remained connected via the seromuscular layers. All dogs survived the operation and lost minimal weight; fistulas were not found between the remnant stomach and the pouch at necropsy 6 to 8 weeks later. Gastric acid secretion for 30 to 90 min after insulin-induced hypoglycemia, which increases vagal tone, was significantly increased compared to that before insulin injection, confirming preservation of vagal innervation to the pouch. Our technique to create a Pavlov pouch is superior to the methods reported previously because of its simplicity, lower prevalence of fistula formation, and reliable preservation of vagal innervation to the pouch.
本研究的一个目的是建立一种简单的方法来构建巴甫洛夫袋，该方法可避免胃主体与袋之间形成瘘管，同时保留最大程度的迷走神经支配。在四只狗的脾门水平处，从胃体大弯处构建巴甫洛夫袋（迷走神经支配的胃袋）。沿着袋的内侧边缘钝性分离黏膜层和浆肌层之间的平面。将手术吻合器插入黏膜层和浆肌层之间的间隙，在黏膜水平将袋与胃主体完全肠内分离，但通过浆肌层保持连接。所有狗均存活，体重减轻极少；在6至8周后的尸检中，未发现残留胃与袋之间存在瘘管。与胰岛素注射前相比，胰岛素诱导的低血糖（可增加迷走神经张力）后30至90分钟的胃酸分泌显著增加，证实袋的迷走神经支配得以保留。我们创建巴甫洛夫袋的技术优于先前报道的方法，因为它简单、瘘管形成发生率低且能可靠地保留袋的迷走神经支配。
