Altered pancreatic and biliary function after vagotomy and pyloroplasty.
Altered pancreatic and biliary function after vagotomy and pyloroplasty.
复制标题
迷走神经切断术和幽门成形术后胰腺和胆道功能发生改变。
DOI：
10.1016/s0016-5085(74)80075-2
复制
发表时间：
1974
期刊：
影响因子：
29.4
通讯作者：
William H. J. Summerskill
中科院分区：
文献类型：
--
作者：
J. Malagelada;Vay Liang W. Go;William H. J. Summerskill
研究人员对迷走神经切断术和幽门成形术后胰酶分泌和胆囊收缩的变化进行了研究，并与健康志愿者和十二指肠溃疡患者的研究结果进行了比较。在基础条件下，使用十二指肠灌注对内源性胆囊收缩素胰酶 (CCK-PZ)（通过十二指肠内灌注必需氨基酸释放）和静脉给予的外源性（猪）CCK-PZ 作出反应，对总脂肪酶和胆汁酸输出进行定量。迷走神经切断术和幽门成形术后，基础胰酶输出减少，对十二指肠内必需氨基酸灌注和较低剂量静脉注射 CCK-PZ 的反应也减少，但对最大剂量静脉注射 CCK-PZ 的反应正常。相比之下，尽管对十二指肠内必需氨基酸的反应正常，但与健康受试者或十二指肠溃疡患者相比，静脉注射 CCK-PZ 的剂量较低时，胆囊收缩发生。我们的结果表明，（a）迷走神经冲动有助于消化间期胰酶的分泌； (b)迷走神经切断术和幽门成形术后，胰腺对CCK-PZ的敏感性降低，而胆囊的敏感性增加。
Changes in pancreatic enzyme secretion and gallbladder contraction occurring after vagotomy and pyloroplasty were investigated and compared with findings from healthy volunteers and patients with duodenal ulcer. Total lipase and bile acid outputs were quantified, using duodenal perfusion, under basal conditions and in response to both endogenous cholecystokinin-pancreozymin (CCK-PZ) (released by intraduodenal perfusion of essential amino acids) and to exogenous (porcine) CCK-PZ given by vein. After vagotomy and pyloroplasty, basal pancreatic enzyme outputs were reduced, as were responses to both intraduodenal essential amino acid perfusion and lower doses of intravenous CCK-PZ, but the response to maximal doses of intravenous CCK-PZ was normal. By contrast, gallbladder contraction occurred at a lower dose of intravenous CCK-PZ than in healthy subjects or in patients with duodenal ulcer, although the response to intraduodenal essential amino acids was normal. Our results suggest that (a) vagal impulses contribute to pancreatic enzyme secretion in the interdigestive periods; and (b) after vagotomy and pyloroplasty, sensitivity of the pancreas to CCK-PZ decreases and that of the gallbladder increases.