Experimental studies on dilatation of rabbit bile duct after pancreatico-biliary anastomosis

先天性胆管扩张通常与Oddi括约肌上方的胰管和胆管异常有关。然而，异常愈合并不总是导致胆管扩张。为探讨异常愈合与胆管扩张的病因学关系，我们用细聚乙烯管和细T管制作兔胰胆管吻合术，然后肌注。每日服用促胰液素(1U/kg)和/或雨蛙素(100 ng-kg)，最多6个月。胆管扩张逐渐加重，2~3个月达最大。单纯胰胆管吻合术可引起胆管中度扩张(平均胆管直径为11.9 mm，正常对照组为3.5 mm)。每日给予促胰液素(14.5 mm)对胆管扩张有促进作用，其中以促胰液素和雨蛙素联合应用(20.5 mm)最为显著。胆红素、α-磷酸酶、谷草转氨酶、谷丙转氨酶和淀粉酶水平均在正常范围内，提示异常愈合时，胰腺分泌增加，Oddi括约肌和胆囊壁收缩，可能促进胆管扩张。

Congenital bile duct dilatation is usually associated with the abnormal uinon of pancreatic and biliary ducts above Oddi's sphincter. Abnormal union, however, does not always induce bile duct dilatation. To investigate the etiological relationships between abnormal union and bile duct dilatation, we made pancreatico-biliary anastomosis in rabbit using thin polyethylene tube and thin T tube, and afterwards administered im. secretin(1 U/kg) and/or caerulein(100 ng-kg) daily for atmost six months. Bile duct dilatation proceeded gradually, reaching to the maximum at 2-3 months. Even mere pancreatico-biliary anastomosis without stimulation provoked a moderate dilatation of bile duct (average bile duct diameter was 11.9 mm as compared with 3.5 mm in normal control). Bile duct dilatation was enhanced by daily administration of secretin(14.5 mm) and most remarkably by together administration of secretin and caerulein(20.5 mm). In the dilated duct pressure increased and the large amounts of pancreatic enzymes were found unactivated.Serum levels of bilirubin, A1-Pase, GOT,GPT and amylase were within normal limits It was suggested that the increase of pancreatic secretion and contraction of Oddi's sphincter and gallbladder might enhance the bile duct dilatation in abnormal union.