Oral (99m)Tc-DTPA simultaneous determination of duodenobiliary reflux and intestinal permeability in patients after choledocholithotomy plus T-tube drainage.
BACKGROUND
The high choledocholithiasis recurrence rate after choledocholithotomy plus T-tube drainage is related to biliary bacterial infection. These bacteria are from the intestine, either via the major duodenal papilla, or the penetrating intestinal mucosa. It is therefore possible that duodenobiliary reflux and increased intestinal permeability exist in patients who have undergone choledocholithotomy. This study was undertaken to find the evidence of duodenobiliary reflux and to assess intestinal permeability in these patients.


METHODS
Twenty-one patients who underwent choledocholithotomy plus T-tube drainage 2 months ago, and 11 healthy volunteers (controls) took orally 185MBq of (99m)Tc-DTPA. The patients' bile was collected in the next 2 hours via a T-tube and the (99m)Tc-DTPA radioactivity in the bile was counted. Intestinal permeability was evaluated by measuring the 24-hour urinary excretion rate of ingested (99m)Tc-DTPA in both patients and controls.


RESULTS
In 6 of the 21 patients, radioactivity in the bile was detected. The intestinal permeability was significantly higher in patients (11.45%+/-6.16%) than that in controls (3.61%+/-1.63%, t=3.28, P<0.05).


CONCLUSIONS
Duodenobiliary reflux exists in patients who have undergone choledocholithotomy plus T-tube drainage. The intestinal permeability is higher in these patients than in healthy subjects. Duodenobiliary reflux and increased intestinal permeability may be factors of cholelithiasis recurrence.
Sun
Shao-Long
SL
Department of General Surgery, Institute of Clinical Medicine, Second Affiliated Hospital, China Medical University, Shenyang 110004, China.
Wu
Shuo-Dong
SD
Zhang
Xiao-Bo
XB
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D002768:Choledochostomy / Q000379:methods*; D004322:Drainage; D005260:Female; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology*; D007413:Intestinal Mucosa / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000652:urine; D012016:Reference Values; D016284:Technetium Tc 99m Pentetate / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000652:urine
D019275:Radiopharmaceuticals; D016284:Technetium Tc 99m Pentetate