title: The cholecystocolic bypass with jejunal interposition graft for bile acid depletion in bile and portal blood in guinea pigs.
abstract: Ileal bypass and cholecystostomy are used in children with selected cholestatic diseases to lower the bile acid (BA) levels in bile and blood and improve outcome. The efficacy of a cholecystocolic bypass in achieving the same goals was investigated in guinea pigs. In the study group (n=7), a cholecystocolic bypass was performed using a jejunal graft interposed between the gallbladder and the cecum. In the control group (n=5), a cholecystojejunal bypass was performed with a similar graft implanted in the proximal jejunum. Total BA concentration was measured in bile and portal blood at surgery (D0) and 30 days later (D30) by pooling the concentrations of 7 individual BA. D30/D0 BA ratios were compared. All animals developed normally without clinical symptoms. A 76% reduction in the bile T-BA levels was observed in both groups (p<0.05). A 80% decrease of T-BA levels was observed in portal vein in study group (p<0.05), suggesting that ileal bile flow and BA ileal reabsorption were highly impaired. No change in portal vein BA levels was observed in control group. Cholecystocolic bypass led to a significant loss of bile acids in guinea pigs and might be considered for bile diversion in pediatric patients with selected cholestatic diseases.
authors.affiliation: Department of Pediatric Surgery, Hôpital d'Enfants de la Timone, 13385 Marseille Cedex 5, France. arnauld.delarue@ap-hm.fr
authors.forename: A
authors.initials: A
authors.lastname: Delarue
authors.forename: M F
authors.initials: MF
authors.lastname: Gerhardt
authors.forename: T
authors.initials: T
authors.lastname: Merrot
authors.forename: B
authors.initials: B
authors.lastname: Roquelaure
authors.forename: J M
authors.initials: JM
authors.lastname: Guys
authors.forename: F
authors.initials: F
authors.lastname: Trivin
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D001646:Bile / Q000502:physiology*; D001647:Bile Acids and Salts / Q000032:analysis; D001774:Blood Chemical Analysis; D002432:Cecum / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D005704:Gallbladder / Q000601:surgery*; D006168:Guinea Pigs; D007583:Jejunum / Q000601:surgery*; D023421:Models, Animal; D011169:Portal Vein
chemical_list: D001647:Bile Acids and Salts