Effects of structural injure in the bile bacterial contamination after balloon transduodenal sphincteroplasty (papillary dilation) in dogs.
OBJECTIVE
To evaluate, in dogs, the biliary sphincter subjected to dilation by hydrostatic balloon by the point of view of structural alterations of the papilla and the biochemestry and bacterial contamination of the bile.


METHODS
Twenty dogs were submitted to laparotomy, duodenotomy, and enlargement of the major duodenal papilla- GA(n=10) - with balloon of 8mm inflated with pressure of 0,5 atm, during 2 minutes or to the sham procedure - GB(n=10). Blood samples collected on times t(0 day), t(7 days) and t(28 days) were subjected to dosages of alkaline phosphatase (ALP) and gamma-glutamyltransferase (GGT) for cholestasis evaluation. The collected material from the gall bladder at the same times were registered and numbered to be submitted to culture in BHI, blood agar (rich, non-selective element) and Mac Conkey (selective element for Gram-negative bacillus. On the 28th day three fragments of the papilla were tranversally cut by the choledoc axis 3mm from the duodenal papilla and the cuts, stained with hematoxylin-eosin and Masson's tricome, were evaluated according to their inflammatory reaction.


RESULTS
The GGT and ALP averages on the three periods in the groups A and B did not show significant differences, not being characterizes the cholestasis. The bacterian contamination was significantly higher in GA (2,19) than in GB (1,96); the contamination was lower in the initial time compared with 7 and 28 days (t0<t7 and t 28) in GA and GB (t0<t 28). The chronic inflammatory alteration of the mucosa occurred in 60% of the GA animals and in 80% of the GB animals. There was not mural inflammation.


CONCLUSIONS
The duodenal papilla dilation or its simple manipulation leads to the bacterial contamination of the gall bladder, not associated with cholestasis. The morphologic lesions are more intense in the late phase, not associated with an eventual papilla esthenosis.
Zavadinack Netto
Martin
M
Postgraduate Program in Surgery and Experimentation, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
Fagundes
Djalma José
DJ
Bandeira
César Orlando Peralta
CO
D000469:Alkaline Phosphatase / Q000097:blood; D000818:Animals; D001424:Bacterial Infections / Q000382:microbiology*; D001646:Bile / Q000382:microbiology*; D002404:Catheterization; D016009:Chi-Square Distribution; D002779:Cholestasis / Q000382:microbiology; D004195:Disease Models, Animal; D004285:Dogs; D004927:Escherichia coli Infections / Q000382:microbiology; D011552:Pseudomonas Infections / Q000382:microbiology; D009803:Sphincter of Oddi / Q000382:microbiology / Q000473:pathology* / Q000601:surgery; D013105:Sphincterotomy, Transduodenal; D013203:Staphylococcal Infections / Q000382:microbiology; D018709:Statistics, Nonparametric; D013530:Surgical Wound Infection / Q000382:microbiology / Q000473:pathology*; D005723:gamma-Glutamyltransferase / Q000097:blood
D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase