Effects of Proximal Duodenal Transection and Anastomosis on Interdigestive Sphincter of Oddi Cyclic Motility in Conscious Dogs

Deng, Zhou-Lu; Nabae, Toshinaga; Konomi, Hiroyuki; Takahata, Shunichi; Yokohata, Kazunori; Ogawa, Yoshiaki; Chijiiwa, Kazuo; Tanaka, Masao

doi:10.1007/s002680010138

Cited by 18 publications

(19 citation statements)

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“…[31][32][33] Our recent study showed that CCK exhibited a "paradoxical" response of contraction instead of relaxation after proximal duodenal transection and anastomosis in conscious dogs. 34 In postgastrectomy patients, Odani et al 17 also observed the paradoxical SO response to cerulein. In the present study, truncal vagotomy failed to change the effect of CCK on the SO basal pressure and amplitude.…”

Section: Discussionmentioning

confidence: 97%

Effect of Truncal Vagotomy on Sphincter of Oddi Cyclic Motility in Conscious Dogs

Nabae

Yokohata

Otsuka³

et al. 2002

Annals of Surgery

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ObjectiveTo evaluate the effects of truncal vagotomy at the diaphragmatic level on the sphincter of Oddi (SO) motility. Summary Background DataCholelithiasis is a well-known late complication after gastrectomy and/or vagotomy. The mechanism of gallstone formation is only partly understood, and few studies address the effects of vagotomy on SO cyclic motility in conscious subjects. MethodsIn conscious dogs, SO motility was recorded by retrograde infusion manometry through a duodenal cannula before and after bilateral truncal vagotomy at the diaphragmatic level. Effects of cholecystokinin-octapeptide and feeding were also evaluated before and after vagotomy. ResultsSO cyclic motility and the gastroduodenal migrating motor complex continued to occur during postvagotomy fasting. Intermittent inhibitions of the SO and duodenal contractions disappeared during phase 3 of the migrating motor complex. SO basal pressure significantly decreased, whereas the amplitude significantly increased. Cholecystokinin-octapeptide inhibited SO contractions before and after vagotomy. The amplitude of SO contractions increased and their frequency decreased after feeding; however, these effects disappeared after vagotomy. ConclusionsSO cyclic motility and the effects of feeding change after truncal vagotomy at the diaphragmatic level. These facts may at least partly explain gallstone formation after gastric surgery and/or vagotomy.

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Section: Discussionmentioning

confidence: 97%

Effect of Truncal Vagotomy on Sphincter of Oddi Cyclic Motility in Conscious Dogs

Nabae

Yokohata

Otsuka³

et al. 2002

Annals of Surgery

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“…Early in the 1890, Courvoisier found that 14% of the patients with common bile duct stones had dilation of the duodenal ampulla. Deng et al [18] found that the mean contraction period was shortened (P < 0.02), and that the frequency (P < 0.005) and amplitude (P < 0.001) of sphincter phasic waves during phase Ⅲ were decreased in the patients with proximal duodenal transection performed during gastrectomy; this suggested that duodenal transection produced significant changes in interdigestive sphincter of Oddi motility, possibly contributing to augmented duodenobiliary reflux and then lithogenesis. There were many case reports about www.wjgnet.com…”

Section: Discussionmentioning

confidence: 99%

Sphincter of Oddi hypomotility and its relationship with duodenal-biliary reflux, plasma motilin and serum gastrin

Zhang¹,

Wu²,

Wang³

et al. 2008

WJG

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group (t = 5.254, 3.438 and 3.527, P < 0.001). SOD of the reflux group was shorter than the control group (t = 2.049, P < 0.05). The level of serum gastrin and plasma motilin of the reflux group was much lower than the control group (t = -2.230 and -2.235, P < 0.05). There was positive correlation between the level of plasma motilin and SOBP and between the level of serum gastrin and SOBP and CBDP. CONCLUSION: About 35.9% of the patients with a T tube after cholecystectomy and choledochotomy have duodenal-biliary reflux. Most of them have sphincter of Oddi hypomotility and the decreased level of plasma motilin and serum gastrin. The disorder of gastrointestinal hormone secretion may result in sphincter of Oddi dysfunction. There is a close relationship between sphincter of Oddi hypomotility and duodenal-biliary reflux. INTRODUCTIONEndoscopic sphincterotomy (EST) is an important surgery to treat choledocholithiasis. About 50% of the patients after EST had biliary gas indicating reflux of duodenal contents [1] . The duodenal-biliary reflux rate was as high as 100% in the patients after EST [2] . The stone recurrence rate was 9.8% in the patients with EST [3] , but in the patients after cholecystectomy for gallbladder stones, the choledocholithiasis recurrence rate was only about 2.5% [4] . Thus, EST destroyed the sphincter of Oddi, resulting in duodenal-biliary reflux which may have close relationship with the recurrence of choledocholithiasis. Abstract AIM: To detect whether patients with a T tube after cholecystectomy and choledochotomy have duodenalbiliary reflux by measuring the radioactivity of Tc99m-labeled diethylene triamine penta-acetic acid (DTPA) in the bile and whether the patients with duodenal-biliary reflux have sphincter of Oddi hypomotility, by measuring the level of plasma and serum gastrin of the patients. Finally to if there is close relationship among sphincter of Oddi hypomotility, duodenal-biliary reflux and gastrointestinal peptides. METHODS: Forty-five patients with a T tube after cholecystectomy and choledochotomy were divided into reflux group and control group. The level of plasma and serum gastrin of the patients and of 12 healthy volunteers were measured by radioimmunoassay. Thirty-four were selected randomly to undergo choledochoscope manometry. Sphincter of Oddi basal pressure (SOBP), amplitude (SOCA), frequency of contractions (SOF), duration of contractions (SOD), duodenal pressure (DP) and common bile duct pressure (CBDP) were scored and analyzed. RESULTS: Sixteen (35.6%) patients were detected to have duodenal-biliary reflux. SOBP, SOCA and CBDP in the reflux group were much lower than the control

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“…The action of CCK may be mediated by intramural neurons or some hormonal mechanisms derived from the duodenum. Deng et al 9 and Shibata et al 10 showed that transection of the proximal duodenum in dogs changed contraction of the SO in response to CCK to relaxation. Tanaka et al 22 reported that cerulein, a CCK analogue, participated in the activation of SO motility via the intrinsic myoneural pathways, using an SO translocation model in possums.…”

Section: Discussionmentioning

confidence: 99%

“…The SO-duodenal myoneural continuity has been demonstrated to play a role in controlling this coordination. [7][8][9] Cholecystokinin (CCK) is a major hormone physiologically regulating the tone and motility of the biliary system. In humans, SO relaxation and gallbladder contraction are regulated by the release of CCK from the duodenal mucosa after meals, causing bile flow into the duodenum.…”

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confidence: 99%

“…These findings suggest the existence of a CCK-related neural pathway between the SO and the duodenum. Deng et al 9 and Shibata et al 10 showed that transection of the proximal duodenum modified the effects of CCK on SO motility, suggesting that myoneural continuity between the stomach and SO at the proximal duodenum may play an important role in the CCK control of SO motility. However, the role of SO-duodenal myoneural continuity in the effect of CCK on SO motility is not completely understood yet.…”

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confidence: 99%

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Duodenum is important for the sphincter of Oddi motor response to cholecystokinin octapeptide in conscious dogs

et al. 2005

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Effects of Proximal Duodenal Transection and Anastomosis on Interdigestive Sphincter of Oddi Cyclic Motility in Conscious Dogs

Cited by 18 publications

References 35 publications

Effect of Truncal Vagotomy on Sphincter of Oddi Cyclic Motility in Conscious Dogs

Effect of Truncal Vagotomy on Sphincter of Oddi Cyclic Motility in Conscious Dogs

Sphincter of Oddi hypomotility and its relationship with duodenal-biliary reflux, plasma motilin and serum gastrin

Duodenum is important for the sphincter of Oddi motor response to cholecystokinin octapeptide in conscious dogs

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