[Significance of pancreatic and duodenal secretions for the protection of gastrointestinal anastomoses following stomach resection--an animal experiment study].
The consequences of deviation of pancreatic juice and bile after gastric resection were studied in an experimental animal model in 66 rats. After hemigastrectomy and Billroth I resp. Billroth II anastomoses papilla vateri was transplanted into a deep jejunal limb in a B I and a B II group each. Absence of alkaline secretions of Papilla vateri was followed by a marked increase in acidity in the gastric remnant and connected intestine. Especially in the Billroth II operated stomach we found an increased ulcer risk under these circumstances. With additional histamine-stimulation frequency of ulcer was 75% in Billroth II but only 33% in Billroth I animals. When alkaline reflux was preserved the ulcer rate ranged from 15 to 40% in all groups. These results confirmed the protective property of postresectional reflux for the integrity of anastomoses after gastric resection. The increased resistance of Billroth I anastomoses in spite of deficient luminal acid buffers could be explained by the mucus-bicarbonate-barrier of the duodenal mucosa.
Baumann
M
M
Abteilung Chirurgie der Medizinischen Fakultät der RWTH Aachen.
Arlt
G
G
Winkeltau
G
G
Schumpelick
V
V
D000714:Anastomosis, Surgical; D000818:Animals; D001646:Bile / Q000502:physiology*; D005743:Gastrectomy; D005745:Gastric Acidity Determination; D005750:Gastric Juice / Q000502:physiology; D005755:Gastrins / Q000097:blood; D008297:Male; D010189:Pancreatic Juice / Q000502:physiology*; D051381:Rats; D011919:Rats, Inbred Strains; D012307:Risk Factors; D013276:Stomach Ulcer / Q000503:physiopathology; D014945:Wound Healing
D005755:Gastrins
Bedeutung von Pankreas- und Duodenalsekreten für die Protektion gastroenteraler Anastomosen nach Magenresektion--Eine tierexperimentelle Studie.