Establishment of experimentally reflux esophagitis after distal partial gastrectomy in rats and pathophysiological investigation.

[背景]残胃十二指肠液和残胃酸在胃大部切除术后反流性食管炎的发生中起重要作用。采用Biliroth Ⅰ法，在大鼠胃十二指肠前切除吻合术中，建立了实验性反流性食管模型。但食管炎的发生率和生存率较低（2002年报道）。本研究尝试建立胃切除术后反流性食管炎的动物模型。[材料与方法]采用5组大鼠。第1组;对照组（第2组）;胃窦切除后胃十二指肠吻合术（第3组）;十二指肠乳头远侧周围覆盖细导管组（第2组）、细导管组（第4组）;界嵴结扎组（第2组）、界嵴结扎组（第5组）;界嵴结扎组（第3组）。在实验开始后2周将动物处死。[结果]（1）存活率：第1组100%，第2组50%，第3组50%，第4组40%，第5组40%。(2)食管炎的发生率，第1组为0%，第2组为40%，第3组为60%，第4组为75%，第5组为100%。(3)组织学检查：食管炎大鼠食管上皮明显增厚，固有层乳头向上皮内延伸，固有层内有炎性细胞浸润。[结论]结扎界嵴是实验性远端胃切除术后反流性食管炎的重要环节。

【Background】 Duodenal juice and acid in the remnant stomach would play important roll in reflux esophagitis after distal partial gastrectomy. We could make experimentally reflux esophagits in rats with anterectomy and gastroduododenal anastomosis (Biliroth I method). However, occurrence ratio of esophagitis and survival ratio were low (report in 2002). We retried to make some model for reflux esophagitis after gastrectomy. 【Materials and method】 We used five group of rats. Group 1 ; the control group, Group 2 ; gastroduodenal anastomosis after antrectomy, Group 3 ; covered with a thin catheter around duodenum at distal side of papilla vater in group 2, Group 4 ; ligation of limiting ridge (between the glandular portion and the forestomcb) in group 2, Group 5 ; ligation of limiting ridge in group 3. The animals were sacrifled 2 weeks after the start of experiment. We investigated the lesion of the esophagus macroscopically and histologically and measured remnant gastric pH. 【Results】 (1) Survival ratio : 100% in group 1, 50% in group 2, 50% in group 3, 40% in group 4, 40% in group 5, respectively. (2) Occurrence ratio of esophagitis 0% in group 1, 40% in group 2, 60% in group 3, 75% in group 4, 100% in group 5. (3) Histological examination : Marked thickening of the esophageal epitheliuxn, the elongation of papillae of the lainina propria into the epithelium and infiltration of inflammatory cells in the lamina propria were remarkable in the rats with esophagitis. 【Conclusion】 Ligation of limiting ridge was an important point in experimentally reflux esophagitis after distal gastrectomy.