肠胆反流对胆管胆色素结石形成的影响
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金俊哲, 吴硕东, 苏 洋, 张振海, 张立魁,
肠胆反流;胆色素结石;细菌;内毒素;淀粉酶;脂肪酶;β-葡萄糖醛酸酶,金俊哲,吴硕东,苏洋,张振海,张立魁,孔静,通讯作者:,Influenceofduodena
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金俊哲, 吴硕东, 苏洋, 张振海, 张立魁, 孔静, 中国医科大学附属二院普外二科 辽宁省沈阳市 110004
通讯作者: 吴硕东, 110004, 辽宁省沈阳市和平区三好街36号, 中国医科大学附属二院普外二科. jccccj@sina.com
电话: 024-83955062
收稿日期: 2006-02-06 接受日期: 2006-02-21
Influence of duodenal-biliary reflux on formation of bile duct pigment gallstone
Jun-Zhe Jin, Shuo-Dong Wu, Yang Su, Zhen-Hai Zhang, Li-Kui Zhang, Jing Kong
Jun-Zhe Jin, Shuo-Dong Wu, Yang Su, Zhen-Hai Zhang, Li-Kui Zhang, Jing Kong, the Second Department of General Surgery, the Second Affiliated Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Correspondence to: Shuo-Dong Wu, the Second Department of General Surgery, the Second Affiliated Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning Province,China. jccccj@sina.com
Received: 2006-02-06 Accepted: 2006-02-21
Abstract
AIM: To investigate the possible action and mechanism of duodenal-biliary reflux in the pathogenesis of bile duct pigment gallstone.
METHODS: Forty-eight patients were divided into three groups: polyp of gallbladder (PG,n = 10), cholecystolithiasis (CH,n = 27) and calculus of bile duct (CBD, n = 11). Bile samples were collected during operation for bacterial culture and endotoxin examination. Forty-one patients received T tube drainage after cholecystectomy and choledochotomy were divided into reflux (n = 16) and non-reflux group (n = 25) according to radionuclide examination. The activity of biliary amylase, lipase and β-glucuronidase were detected in 26 of the 41 patients.
RESULTS: The positive rate of bacterial culture was 0% in PG group, 0% in CH group and 81.8% in CBD group, and the level of endotoxin in bile was (0.003 ± 0.004) × 10-6, (0.01 ± 0.02) × 10-6, and (10.12 ± 4.49) × 10-6 EU/L the above corresponding group, respectively. Compared with those in the former two groups, the positive rate and endotoxin level were higher in the latter CBD group (P < 0 ......
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