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KMID : 0438219720090010221
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Korea University Medical Journal
1972 Volume.9 No. 1 p.221 ~ p.234
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Experimental Study on the Choledochojejunostomy and Roux-en-Y Choledochojejunostomy
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Abstract
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Numerous works have been reported concerning decompression technics for the obstructed common bile duct since Longuet in 1896. However, any one method, determined to be superior to others, is still an unsettled matter. As measures of biliary decompression, author performed following experiment; Ten dogs were operated to induce complete occlusion of the common bile duct. Two weeks later, 5 of which were decompressed
with choledochojejunostomy and the remainings with Roux-en-Y choledochojejunostomy procedure. Changes of hematologic pictures, biochemical changes of serum components, bacteriological findings of
bile, biliary intestinal reflux and histopathological findings of the liver were observed respectively. Followings were the results :
1. There were no remarkable hematologic difference except leukocytosis in the groups of common bile duct occlusion and biliary-intestinal anastomosis comparing with control group.
2. Alkaline phosphatase activity, S-GOT, S-GPT, total bilirubin and thymol turbidity were highly increased after occlusion of common bile duct. These serum components returned to almost normal level in the group of Roux-en-Y choledochojejunostomy, but slightly decreased in the choledochojejunostomy group.
3. The bile cultures of the control group, the occluded common bile duct group and 2 dogs of Roux-en -Y choledochojejunostomy group, were sterile but in all of the choledochojejunostomy group and 3 dogs of Roux-en-Y group, E. coli were isolated.
4. The anastomosed stomas between common bile duct and jejunum were stenosed slightly to moderately. Infection and reflux of the intestinal contents into the biliary tract were noted in all cases of biliary -intestinal decompression and they were more remarkable in the choledochojejunostomy group than in Roux-en-Y choledochojejunostomy group.
5. Pathohistologically, Roux-en-Y decompression group appeared to be somewhat better than choledochojejunostomy group in recovery processes.
6. In summary, Roux-en-Y choledochojejunostomy was superior to choledochojejunostomy as a biliary decompression measure.
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