Published online Oct 15, 1998. doi: 10.3748/wjg.v4.iSuppl2.107
Revised: August 7, 1998
Accepted: August 27, 1998
Published online: October 15, 1998
AIM: To observe the effect of cholecystectomy on retrograde fl ow of bile in the pylorus.
METHODS: Thirty patients with gallbladder stone were diagnosed by B ultrasound and received cholecystectomy. Of them, there are 11 men and 19 women aged 32-65 years. The average age is 43.3 years. There are 7 patients with single gallbladder stone of 0.7-3.0 cm in diameter, 14 patients with 2-5 gallbladder stones of 0.4 cm and 2.0 cm in diameter, and 9 patients with silt filling gallbladder stones. The doctor who operated on the patients checked everyone 30 d before and after operation, with JF-IT 30 model of fiber duodenoscope. So the doctor could observe the degree of retrograde flow of bile in pylorus as well as the bild remains in bulbus duodenum.
RESULTS: Before the gallbladder was resected, 7 patients had a small amount of retrograde flow of bile in the ostium pylorus, two patients had moderate amount, 21 patients had no. After cholecystectomy, 8 patients had a small amount of retrograde flow of bile in ostium pylorus. The patients with mode rate amount of retrograde flow of bile were 15, and 4 had a great amount of retrograde flow of bile into their stomaches. Only 3 without any retrograde flow of bile. Before the patients' gallbladders were resected, there was a little remains in the bulbus duodenum in 25 patients, moderate amount in 5. Then after cholecystectomy, there are 4 patients with a little remains, 19 with moderate amount, and 7 with a great amount of bile remained in bulbus duodenum. The degree of retrograde flow of bile in ostium pylorus was postively proportionate to that of bile remains in bulbus duodenum.
CONCLUSION: After cholecystectomy, the bile remains in the boltbus duodenum increase endently, which increase pressure of the bulbus duodenum and the pylorus. This makes the function of sphincter muscle of pylorus decline, and the function of pyloric shutting is restricted.