Bile acid retention after Roux-en-Y biliary reconstruction demonstrated by tauro-23-(75Se)selena-25-homocholic acid. An experimental animal study.
In this study of 65 laboratory rats the influence of biliary Roux-en-Y anastomosis on the enterohepatic circulation was investigated. Three different types of Roux-en-Y limbs were studied and compared with sham-operated controls. To collect information about the influence of the length and motility of the Roux limb, 10-cm and 3-cm isoperistaltic Roux segments and 10-cm anisoperistaltic Roux limbs were investigated. 75SeHCAT, a tau-labelled synthetic bile acid, was used for assessment of enterohepatic circulation. Intestinal transit time was evaluated by measuring the decrease of whole-body counts of 51Cr-labelled ethylenediamintetraacetic acid (EDTA), an inert marker of intraluminal contents. 99mTc-labelled dimethyl-iminodiacetic acid (HIDA) was used to detect possible alterations of bile flow. 75SeHCAT results showed marked retention of bile acids in all Roux-en-Y animals compared with controls. Results of short and long Roux limbs did not differ significantly from each other (t1/2 10 cm, 59.8 h; 3 cm, 59.3 h; control, 42.6 h; p less than or equal to 0.001). The anisoperistaltic Roux limbs showed prolonged retention even when compared with isoperistaltic limbs (t1/2 98.6 h; p less than or equal to 0.001). 51Cr-EDTA results did not show significant differences between all groups. 99mTc-HIDA showed undelayed excretion in all animals but increase of radioactivity at the site of the Roux-en-Y enteroanastomosis, indicating marked stasis in the biliodigestive Roux limb. The results demonstrate the impact of biliary Roux-en-Y anastomosis on bile acid retention due to stasis in the defunctioning jejunal segment.
Bolder
U
U
Dept. of Surgery, Medical Faculty, Rhenish-Westfalian Technical University, Aachen, FRG.
Bares
R
R
Arlt
G
G
Hojabri
K
K
Schumpelick
V
V
D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects / Q000379:methods; D000818:Animals; D001647:Bile Acids and Salts / Q000378:metabolism*; D001659:Biliary Tract / Q000378:metabolism*; D001662:Biliary Tract Surgical Procedures; D004764:Enterohepatic Circulation; D008297:Male; D051381:Rats; D011919:Rats, Inbred Strains; D013656:Taurocholic Acid / Q000031:analogs & derivatives / Q000378:metabolism
D001647:Bile Acids and Salts; D013656:Taurocholic Acid; C033638:23-seleno-25-homotaurocholic acid