Long-Term Bile Diversion Enhances Basal and Duodenal Oleate-Stimulated Pancreatic Exocrine Secretion in Dogs
MICHINAGA TAKAHASHI, HIROO NAITO, IWAO SASAKI,1 YUJI FUNAYAMA,1 CHIKASHI SHIBATA1 and SEIKI MATSUNO1
South Miyagi Medical Center, Ohgawara 989-1253, and 1First Department of Surgery, Tohoku University School of Medicine, Sendai 980-8574
There have been no previous reports whether long-term bile diversion enhances pancreatic exocrine secretion. The aim of this study was to elucidate the effect of long-term bile diversion on pancreatic exocrine secretion. Four mongrel dogs were prepared for chronic gastric and pancreatic fistulas and received intraduodenal sodium oleate infusion (controls). These dogs, then underwent diversion of bile from the intestines by ligating the common bile duct and interposing a segment of jejunum between the gallbladder and the urinary bladder (total biliary diversion [TBD]). After three weeks, the dogs received an identical sodium oleate infusion. TBD augmented basal pancreatic exocrine secretion compared with controls (4.4-fold increase in basal flow volume; 9.0-fold increase in bicarbonate output; and 3.3-fold increase in protein output). Likewise, TBD augmented oleate-stimulated exocrine secretion (2.0-fold increase in cumulative flow volume; 2.6-fold increase in bicarbonate output; and 1.4-fold increase in protein output). TBD also augmented basal and oleate-stimulated plasma cholecystokinin levels. Administration of a Cholecystokinin-A receptor antagonist (loxiglumide) after TBD reduced the flow volume and bicarbonate output to the control levels, and the protein output to less than a half of the control level. Long-term bile diversion enhances basal and oleate-stimulated pancreatic exocrine secretion, at least partly via increased cholecystokinin secretion.
keywords —— biliary diversion; chronic pancreatic fistula; pancreatic exocrine secretion; cholecystokinin; loxiglumide
© 2004 Tohoku University Medical Press
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Tohoku J. Exp. Med., 2004, 203, 87-95
Address for reprints: Seiki Matsuno, M.D., Ph.D., First Department of Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aoba-ku, Sendai 980-8574, Japan.
e-mail : m.takahashi@southmiyagi-mc.jp, smatsuno@surg1.med.tohoku.ac.jp