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

先天性胆管扩张通常与Oddi括约肌上方胰腺和胆管的异常结合有关。然而，不正常的愈合并不总是引起胆管扩张。为探讨胆总管扩张与胰胆异常愈合的病因关系，我们采用薄聚乙烯管和薄T管对家兔进行胰胆吻合，术后给药。分泌素（1u /kg）和/或粟粒素（100ng -kg），每天服用最多6个月。胆管扩张逐渐进行，在2-3个月时达到最大。即使仅仅是胰胆吻合术，在没有刺激的情况下，也会引起胆管的适度扩张（平均胆管直径为11.9 mm，而正常对照组为3.5 mm）。每日给药分泌素（14.5 mm）可增强胆管扩张，同时给药分泌素和小黄蛋白（20.5 mm）可增强胆管扩张。在扩张的导管中，压力增加，大量胰酶未被激活。血清胆红素、A1-Pase、GOT、GPT、淀粉酶水平均在正常范围内，提示胰腺分泌增加、Oddi括约肌和胆囊收缩可能促进了异常愈合时胆管扩张。

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.