title: Hepatobiliary physiological changes after Roux-en-Y cholecysto-colonic diversion.
abstract: BACKGROUND
  We speculated that Roux-en-Y cholecysto-colonic diversion was as effective for treating children with progressive familial intrahepatic cholestasis (PFIC) as partial biliary diversion. The feasibility of the novel approach in bypassing bile was investigated in rabbits.
  
  
  METHODS
  Twenty-four rabbits were randomly divided into three groups: sham operated group (Group1), 30cm limb group (Group 2), and 10 cm limb group (Group 3). Group 2 or 3 underwent a Roux-en-Y cholecystocolonic anastomoses with a 30- or 10-cm-long Roux limb. (99mTc)EHIDA dynamic biligraphy was used to detect alterations of bile flow among the three groups at 1 year postoperatively. TBA levels and histological changes were also evaluated.
  
  
  RESULTS
  All animals survived and developed normally without clinical symptoms during 1 year follow-up. Bile was diverted into colon directly after cholecystocolonic anastomosis. In group 3, E20 and E35 values were (77.27 ± 6.15%) and (90.39 ± 1.49%) respectively. Gallbladder emptying was accelerated in 10 cm short limb group than in 30 cm long limb group. The ratio of bile shunt was (0.547 ± 0.182), which was also more than that in group 2 (p<0.05). The activity-time curve for the gallbladder area in group 2 looks like a wave. A significant reduction in TBA level was observed in group 2 and 3 (p<0.05).
  
  
  CONCLUSIONS
  Roux-en-Y cholecystocolonic bypass was safe and feasible. Its effectiveness is related to the length of Roux loop. Cholecystocolonic bypass led to a significant loss of bile acids in healthy rabbits and might be considered for bile diversion in pediatric patients with selected cholestatic diseases.
authors: Department of Pediatric Cardiac Surgery Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100037 Beijing, P. R. China. Electronic address: saturn_liu@163.com.
authors: Yao
authors: Y
authors: Liu
authors: Department of Surgery, Capital Institute of Pediatrics, 100020 Beijing, P.R. China.
authors: Wenying
authors: W
authors: Hou
authors: Department of Surgery, Capital Institute of Pediatrics, 100020 Beijing, P.R. China. Electronic address: lilong23@126.com.
authors: Long
authors: L
authors: Li
authors: Department of Surgery, Beijing United Family Hospital, China; Departments of Paediatrics and Surgery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia. Electronic address: wei.cheng@monash.edu.
authors: Wei
authors: W
authors: Cheng
mesh_terms: D000713:Anastomosis, Roux-en-Y / Q000379:methods; D000818:Animals; D001646:Bile / Q000502:physiology*; D001647:Bile Acids and Salts / Q000097:blood / Q000378:metabolism; D002780:Cholestasis, Intrahepatic / Q000503:physiopathology / Q000601:surgery*; D003106:Colon / Q000601:surgery*; D004195:Disease Models, Animal; D005240:Feasibility Studies; D005704:Gallbladder / Q000033:anatomy & histology / Q000502:physiology; D006801:Humans; D008099:Liver / Q000033:anatomy & histology / Q000502:physiology*; D008297:Male; D011817:Rabbits; D011897:Random Allocation
chemical_list: D001647:Bile Acids and Salts
keywords: Biliary diversion; Cholecystocolonic bypass; PFIC