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KMID : 0371319870330020129
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Journal of the Korean Surgical Society
1987 Volume.33 No. 2 p.129 ~ p.139
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Effect of Roux-en-Y Choledochojejunostomy on Gastric Acid Secretion and Gastrin in dogs
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Ro Man-Soo
Song Kyung-Hee
Park Yong-Hyun
Kim Soo-Tae
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Abstract
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The cause of an increased incidence of peptic ulcer disease after Roux-en-Y choledochojejunostomy was studied with respect to the secondary gastric hypersecretion due to gastrin mechanism in dogs prepared with Heidenhain pouches. In addition, the independent contributory effect of the factor of biliary diversion versus jejunal defunctionalization in Roux-en-Y choledochojejunostomy on this mechanism was compared. Gastric acid outputs and serum gastrin concentrations at fasting and postprandial states, and antral gastrin contents were measured before and after the procedure of Roux-en-Y choledochojejunostomy, loop choledochojejunostomy for biliary diversion, or Roux-en-Y jejunal typass for jejunal defunct ionalization respectively. Both 24-hour and postprandial Heidenhain pouch acid outputs increased significantly (p < 0 .01) after each procedure without any significant inter procedure difference. Increases in serum gastrin concentrations calculated as integrated responses after feeding were great er(p < 0 .05) after each procedure and there was an excellent inter procedure correlation ( r = 0.977, P < 0 .005) between increases in serum gastrin concentrations and Heidenhain pouch acid outputs. Basal gastrin contents increased significantly(p < 0.01) after each procedure without any significant inter-procedure difference. The results of these studies suggest that the factor of biliary diversion and jejunal defunctionalization in Roux-en-Y choledochojejunostomy independently can induce gastric hypersecretion through a common channel of the mechanism of an altered biosynthesis and release of gastrin.
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KEYWORD
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