膵管胆道合流異常モデルの研究 : I 犬モデルの作成及びその病変の研究

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The purpose of this study is to produce an ideal animal model, just similar to human anomalies and then to solve the pathologicol mechanism of the hepato-biliary disorders according to the pancreatic reflux into biliary tree. The canine models of pancreatic reflux were produced on 15 mongrel adult dogs (12-25 kg) and 10 mongrel puppies (1.5-2.5 kg). The anastomosing method of dorsal pancreatic duct and gall bladder fundus was to make enhanced activation of pancreatic juice in bile according to the secreted enterokinase from the anastomosed duodenal wall. The direct anastomosing method of the dorsal pancreatic duct and the choledochus was employed to make a very similar model to human anomalies. The ventral pancreatic duct was left free without manipulation. Trypsin and elastase have been proven here to be activated in bile, under the existence of enterokinase in pancreatico-cholecystostomy, and without enterokinase in pancreatico-choledochostomy. The mechanism of activation of trypsin without enterokinase has not been solved. With both type anastomoses, only the pathological changes of the choledochus with cylindrical dilatation was produced. With pancreatico-choledochostomy, changes in the choledochal wall was severer. There was only slight change with papilla of Vater, without sclerotic stenosis.
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