[An experimental study on the gastroantrium-cholecystostomy using pylorus sphincter to replace Oddi sphincter for preventing reflux].
OBJECTIVE
This experimental study of gastroantrium-cholecystostomy was designed to identify the possible use of pylorus sphincter as a substitute for Oddi sphincter.


METHODS
Fifteen prairie dogs were randomized to three groups. The dogs in the control group underwent sham operation. The dogs in the first experiment group were subjected to gastroantrium-cholecystostomy and gastrojejunostomy. Meanwhile, two thin tubes were placed in stomach antrium and duodenum separately for post-operative photography. One week after operation, 20% cyctografin (10 ml) was injected into the duodenum through the relevant tube so as to check whether any backflow came out from duodenum to the bile duct. Then, 20% cyctografin (5 ml) was injected into the stomach antrium so as to demonstrate how it went from stomach antrium into duodenum. The samples of liver, stomach, stomach antrium, gallbladder and extra hepatic duct were collected for pathological examinations. The dogs of the second experiment group underwent the same operations, but the samples for pathological examination were collected four weeks after operation.


RESULTS
Roentgenography showed that there was no contrast medium backflowing into the stomach antrium, and the contrast medium could flow from stomach antrium into duodenum smoothly. The results of histo-pathological examination showed that there were no obvious changes in the liver, stomach antrium and bile duct. Under light microscope, a few inflammatory cells could be seen in the gallbladder wall, and the mucosa of stomach was slightly atrophic.


CONCLUSIONS
The gastroantrium-cholecystostomy which uses pylorus sphincter to take over the functions of Oddi sphincter can effectively prevent intestinal juice from flowing back into the bile duct.
Xiong
Xian-ze
XZ
Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Cheng
Nan-sheng
NS
Peng
Qi-fang
QF
Liu
Jiang-wen
JW
Pan
Guang-dong
GD
Yan
Mao-lin
ML
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D002761:Cholangitis / Q000517:prevention & control*; D002763:Cholecystectomy / Q000009:adverse effects* / Q000379:methods; D004285:Dogs; D005260:Female; D005704:Gallbladder / Q000601:surgery; D007582:Jejunostomy; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D011706:Pyloric Antrum / Q000601:surgery; D011708:Pylorus / Q000601:surgery*; D011897:Random Allocation; D009803:Sphincter of Oddi / Q000503:physiopathology; D013270:Stomach / Q000601:surgery