膀胱引流式胰腺移植后Oddi括约肌运动变化的实验研究

The changes of Oddi sphincter motility after canine pancreas transplantation with bladder drainage

目的 研究膀胱引流式胰腺移植后移植物Oddi括约肌功能的变化以及对移植物功能的影响。方法 应用三腔测压管对正常犬、膀胱引流式胰腺移植后犬和离体的犬Oddi括约肌进行测压 ,并检测移植后犬Oddi括约肌的抗反流能力 ,同时监测移植物内外分泌功能。结果 正常犬Oddi括约肌在 ( 18 5± 2 8)mmHg( 1mmHg =0 133kPa)基础压水平上有规律收缩 ,收缩频率为 ( 9 7±1 5 )次 /min ,收缩幅度为 ( 4 7 1± 5 5 )mmHg ,动力指数为 2 36± 5 6。移植后犬胰腺内外分泌功能良好 ,移植物Oddi括约肌失去了正常的收缩规律 ,基础压升高至 ( 2 7 8± 2 8)mmHg ,收缩频率增快至( 13 1± 1 9)次 /min ,但收缩幅度明显缩小至 ( 8 3± 1 8)mmHg ,动力指数无明显变化。胆管残端内压力不随膀胱内压升高而发生变化。结论 膀胱引流式犬胰腺移植后 ,移植物Oddi括约肌丧失了正常的收缩规律 ,基础压升高 ,收缩频率增快 ,但收缩幅度明显缩小 。

Objective To study the changes of canine Oddi sphincter(SO) function after pancreas transplantation with bladder drainage and the effect on the graft function. Methods Normal canine SO,transplant canine SO and canine SO in vitro manometry were performed by triple lumen catheter.At the same time, pancreas endocrine and exocrine function after transplantation were determined. After transplantation,anti reflux function of graft SO was also measured. Results Endocrine and exocrine function of all the transplanted dogs showed that pancreas graft function was good.Basal pressure of SO in control group was (18 5±2 8) mm Hg (1 mm Hg=0 133 kPa).The contraction frequency was (9 7±1 5) per min,the contraction amplitude was (47 1±5 5) mm Hg, the motility index was (236±56). After transplantation, basal pressure increased to (27 8±2 8) mm Hg, frequency increased to (13 1±1 9) per min,amplitude decreased significently to (8 3±1 8) mm Hg. There was no significent difference of motility index. Basal pressure of SO in vitro increased significently to (37 2±5 1) mm Hg.Phasic contraction was not absent. After transplantation,the pressure in the bile duct residual did not increase in accordance with the increase of bladder pressure. Conclusions After pancreas transplantation with bladder drainage, Basal pressure and frequency of canine SO could increase while amplitude could decrease,which provide the anti reflux function of graft SO and may serve as an obstacle to pancreatic juice flow.