胰胆返流与胆道癌关系的实验研究

Experimental study on the relation between pancreaticobiliary reflux and biliary tract cancer

选用杂种犬15条,随机分为3组。A组胰腺与胆囊吻合;B组胰管开口段十二指肠与胆囊吻合;C组空肠与胆囊吻合。三组动物分别于术后4个月～9个月处死病检。结果A、B组术后胆汁淀粉酶明显比术前高(P>0.01);C组术前后胆汁淀粉酶变化不大(P>0.05)。说明A、B组有胰液流入胆囊内。A、B组5条犬胆囊内有胆泥,C组无胆泥。A、B组胆囊粘膜上皮增生明显,3只形成腺肌瘤,2只呈腺瘤样增生,大部分有粘液化生。C组仅有上皮轻度增生及慢性炎细胞浸润。结果表明胰胆返流很可能是胆道癌的重要病因之一。

15 dogs were divided into groups A,B and C at random. Pancreaticocholecystostomy was performed in group A, a part of duodenal wall with pancreatic aperture was transplanted to the gallbladder in group B, and the group C served for control with cholecystoje-junostomy. All experiment animals were killed for pathologic examination in 4 to 9 months postoperatively. The results were; It was observed in groups A and B that the amylase concentration in bile after operation were significantly higher than that before operation (P <0. 001), there was no obvious difference in group C (P>0. 05). These proved that there was Substantial pancreatic juice flowing into the gallbladder in groups A and B. Sludge could grossly be found in gallbladder of 5 dogs in groups A and B, but none in group C. In groups A and B, experiment animals presented pathologic changes as followings: Obvious hy-perplasia of mucosal epithelium of the gallbladder in all dog. and adenomyoma formation in 3, and adenomatoid proliferation in 2. In group C (control), mucosal epithelium presented only slight hyperplasia with chronic inflammatory cells. We conclude that pancreati-cobiliary reflux is probable one of the important factors leading to the biliary tract cancer.