Dahm K, Eichen R, Mitschke H
Langenbecks Arch Chir. 1977 Nov 4;344(2):71-82. doi: 10.1007/BF01259380.
The purpose of this study was to find whether the reflux of bile and pancreatic juices following stomach resection (duodenogastric reflux) enhances the incidence of carcinomas near the gastroenteric anastomosis. 72 male Wistar rats were subjected to stomach resection. The gastroenteric anastomosis (GE) was performed either as short loop anastomosis (Billroth II; n = 39), thus providing a continuous duodenogastric reflux, or as Y-shaped GE (according to Roux; n = 33). By the latter technique, bile and pancreatic juices are derived quantitatively into the jejunum without coming into contact with the remaining part of the stomach. During a period of 33 weeks, operated rats as well as intact animals were given the carcinogen N-methyl-N'-nitro-N-nitrosoguanidine (NG; 120 mg/l) in the drinking water. At autopsy, 33 to 36 weeks after daily oral administration of NG, most of the tumours were found in operated rats undergoing continuous reflux (Billroth II group). In contrast to these findings, the incidence or carcinomas was significantly lower in animals without reflex (Roux group or intact control rats).-The results of our experiments demonstrate that, in rats, the duodenogastric reflux contributes substantially to the development of carcinomas of the resected stomach.
本研究的目的是确定胃切除术后胆汁和胰液反流（十二指肠胃反流）是否会增加胃肠吻合口附近癌症的发生率。72只雄性Wistar大鼠接受了胃切除术。胃肠吻合术（GE）采用短袢吻合术（毕Ⅱ式；n = 39），从而形成持续的十二指肠胃反流，或者采用Y形GE（根据Roux法；n = 33）。通过后一种技术，胆汁和胰液定量进入空肠，而不与胃的其余部分接触。在33周的时间里，给手术大鼠以及完整动物饮用含致癌物N-甲基-N'-硝基-N-亚硝基胍（NG；120 mg/l）的水。尸检时，在每日口服NG 33至36周后，大多数肿瘤发现于经历持续反流的手术大鼠（毕Ⅱ式组）。与这些发现相反，无反流的动物（Roux组或完整对照大鼠）癌症发生率显著较低。我们的实验结果表明，在大鼠中，十二指肠胃反流在很大程度上促进了切除胃的癌症发生。
