EXPERIMENTAL STUDIES ON THE INFLUENCE OF BILIARY DIVERSION UPON GASTRIC SECRETION

Abstract

The present study was done to investigate the influence of biliary diversion upon gastricsecretion in dogs with Heidenhain pouches. Biliary diversion was carried out by the following operative procedures: 1) External biliary drainage; ligation and division of the distal common bile duct and construction of an external biliary fistula by inserting a cannula into the gallbladder, 2)Internal biliary drainage; ligation and division of the distal common bile duct and construction of cholecystojejunostomy en Roux Y by anastomosing the dome of the gallbladder to the jejunum 10cm distal to the ligament of Treitz, with restoration of end-to-side jejunostomy. The following tests in response to a test meal (Dog food 300g) were mainly studied during the control and observation periods after a 3-4 week recovery period; gastric acid secretion and serum gastrin levels. The results obtained are as follows:
In external biliary fistula acid secretion from the Heidenhain pouches showed no increase, while in cholecystojejunostomy en Roux Y Heidenhain pouch secretion showed a significant increase in 4 of the 6 dogs, with the increase rate of 110-330%. In both external biliary fistula and cholecystojejunostomy serum gastrin levels showed no significant change. Also, reversion of first cholecystojejunostomy to second cholecystojejunostomy by anastomosing the jejunal loop to the gallbladder caused significant increase in Heidenhain pouch secretion. Acute gastric ulcer developed in 2 of 6 dogs with cholecystojejunostomy en Roux Y.
These results indicate that gastric hypersecretion induced by biliary diversion may be related to the possibility of the presence of a gastric secretagogue different from gastrin.