Evaluation of hepatobiliary excretion and enterobiliary reflux in rats with biliary obstruction submitted to bilioduodenal or biliojejunal anastomosis.
Bilioduodenal and biliojejunal anastomoses are effective for the treatment of biliary obstruction. The objective of this study was to compare the effects of these anastomoses on hepatobiliary excretion and enterobiliary reflux. Enterobiliary reflux and biliary excretion were evaluated respectively after oral administration of technetium ((99m)Tc) in combination with sodium phytate and intravenous infusion of (99m)Tc with diisopropyl-iminodiacetic acid. Enterobiliary reflux occurred to an equal degree in the bilioduodenal and biliojejunal groups. Maximum hepatic activity time (T(max)) and radiotracer clearance half-time (T(1/2)) were similar in both groups. However, when compared with that found for the sham-operated group, T(max), and T(1/2) were higher in the biliojejunal group (P = 0.02 and P = 0.01, respectively). Histopathological analysis showed marked reduction in ductal proliferation in both groups. These data undermine the theoretical advantages attributed to biliojejunal anastomosis and further the understanding of the pathophysiology of cholangitis that occurs even with patent anastomosis.
Dutra
Robson Azevedo
RA
Department of Surgery and Anatomy, University of São Paulo at Ribeirão Preto School of Medicine, Ribeirao Preto, Sao Paulo 14049-900, Brazil.
Dos Santos
José Sebastião
JS
de Araújo
Whemberton Martins
WM
Simões
Marcus Vinicius
MV
de Paixão-Becker
Aline Nazareth Paiva
AN
Neder
Luciano
L
D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D000818:Animals; D017734:Bile Ducts, Extrahepatic; D001655:Bile Reflux / Q000209:etiology*; D002761:Cholangitis / Q000209:etiology; D001651:Cholestasis, Extrahepatic / Q000378:metabolism* / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D007583:Jejunum / Q000601:surgery*; D008297:Male; D051381:Rats; D017208:Rats, Wistar