摘要
目的 探讨能否利用幽门括约肌来替代 Oddi括约肌。方法 将 15只草原犬随机分为对照组 (5只 ) ,实验组 (10只 )。对照组行开关腹术。实验组手术方式为 :保留胃窦神经支配 ,胃窦与胃体离断后 ,行胃窦胆囊吻合、空肠胃体吻合术。并分别在胃窦和十二指肠置造影用塑料管。在透视下经十二指肠造瘘管、胃窦造瘘管分别注入泛影葡胺 (含碘 30 0 m g/ ml) ,观察有无返流及胃窦内容通过幽门情况。光镜下观察实验组术后 4周肝、胆囊、胆管、胃窦、胃组织学变化。结果 造影结果显示 :无造影剂返流入胃窦 ,造影剂可从胃窦进入十二指肠。光镜下观察实验组术前与术后 4周肝、胃窦、胆管组织学无明显改变 ,胆囊壁有轻度炎性浸润 ,胃体粘膜有轻度萎缩。结论 本实验初步观察结果提示 ,用幽门括约肌代替
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. Conclusion 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.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2005年第1期127-129,共3页
Journal of Sichuan University(Medical Sciences)
基金
四川省科技厅基金 ( 0 0 0 0 18)资助
