The effects of cholecystojejunostomy and biliary drainage on biliary motor.
Simulating physiological neuronal and hormonal conditions during digestive and interdigestive periods, the study identified the changes of the motility of biliary system including bile duct and sphincter of Oddi (SO) before and after cholecystojejunostomy. Thirty-five rabbits were divided into five groups randomly. The experimental groups received the venous injection of CCK 10 ng/kg, erythromycin 10 mg/kg, atropine 3 micrograms/kg and L-NAME 10 mg/kg respectively. Each rabbit underwent manometry through introducing a three-lumen catheter via the papilla retrogradely, using the low-compliance papillary infusion system. Then the gallbladder and the upper segment of the jejunum was anastomosed and the manometric procedures repeated after one week. SO basal pressure was increased, contraction amplitude decreased, contraction time shortened after cholecystojejunostomy. L-NAME, CCK and erythromycin could all excite SO. L-NAME could increase basal pressure and contraction amplitude, CCK increase basal pressure contraction amplitude and frequency, and erythromycin increase contraction amplitude, respectively. But comparing with that before cholecystojejunostomy, the increasing extent was decreased. The tensional and spontaneous contractions of the SO were under the control of the neural and hormonal mechanism. The anastomosis of gallbladder and jejunum and the drainage of bile made the tensional contraction stronger, but the spontaneous contraction weakened after the operation due to the decreases of the sensitivity of SO to hormonal factors. The clinical symptoms may not be relieved when the patients with SO dysfunction accepted cholecystojejunostomy.
Zheng
Qichang
Q
Department of General Surgery, Xiehe Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022.
Chen
Yanglong
Y
D000818:Animals; D002763:Cholecystectomy / Q000009:adverse effects*; D003135:Common Bile Duct / Q000503:physiopathology*; D005260:Female; D016473:Gallbladder Emptying / Q000502:physiology*; D007582:Jejunostomy / Q000009:adverse effects*; D008297:Male; D008365:Manometry / Q000379:methods; D009119:Muscle Contraction; D011184:Postoperative Period; D011817:Rabbits; D011897:Random Allocation; D009803:Sphincter of Oddi / Q000503:physiopathology*