Cholecystectomy in the cat damages pericholedochal nerves and impairs reflex regulation of the sphincter of Oddi. A mechanism for postcholecystectomy biliary dyskinesia.
A recent study demonstrated the activity of the feline sphincter of Oddi to be regulated by the distending pressure in the biliary tract via inhibitory nerves running along the common bile duct. In the present study this mechanism was investigated in cats previously subjected to cholecystectomy. An increment in the hydrostatic pressure in the biliary tree from 0 to 20 cmH2O did not affect the function of the sphincter of Oddi in cholecystectomized cats, but relaxed the sphincter in controls and in cats with sham operation. Morphologic study of the nerve arrangement in the feline extrahepatic biliary tract revealed that cholecystectomy is likely to damage pericholedochal nerves. These experimental observations may have relevance for the development of biliary dyskinesia following cholecystectomy in some patients, and suggest that when performing biliary-tract surgery it is important to preserve nerve fibers running along the common bile duct.
Thune
A
A
Department of Surgery I, University of Gothenburg, Sahlgrenska Sjukhuset, Sweden.
Jivegård
L
L
Conradi
N
N
Svanvik
J
J
D014670:Ampulla of Vater / Q000502:physiology*; D000818:Animals; D001657:Biliary Dyskinesia / Q000209:etiology*; D002415:Cats; D002763:Cholecystectomy / Q000009:adverse effects*; D003135:Common Bile Duct / Q000294:innervation*; D009412:Nerve Fibers / Q000473:pathology / Q000502:physiology*; D012018:Reflex / Q000502:physiology*; D009803:Sphincter of Oddi / Q000502:physiology*