膵管胆道合流異常モデルの研究 : IV 胆汁内逆流膵蛋白分解酵素の活性化動態の検討

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Varous disorders, according to the anomalous pancreatico-biliary ductal union, have beer supposed to be due to the refluxed pancreatic juice into the biliary tree. But the real causes of these disorders have not been clarified so far. In the successive study on the canine models, we used two kind of models: Pancreatico-choledochostomy (P-Ch) and Pancreatico-cholecystostomy (P-Cy). Twenty five P-Ch models and 11 P-Cy models were used in this experiment. Bile juice was collected from gall-bladder in re-laparotomy in one to twelve months after the model-producing procedure. In the daily study on a P-Ch model, the amylase value was changing remarkably, suggesting uneven reflux of pancreatic juice through the biliary tree. Besides the irregularity of zymogen volume, the activity of trypsin was unsettled in this model. It was almost nothing in many instances while the trypsinogen of high volume level as 400-500×10^4U/ml equivalent was kept inactive. In the daily study of a P-Cy model, the amylase and the activated trypsin were kept constantly in high level. Inactive trypaicnogen was kept very little in this model. The direct secretion of pancreatic juice into gall-bladder would be the cause of this phenomenon. The correlation of the amylase and the secreted trypsinogen amount was studied on 31 bile samples of P-Ch and 22 samples of P-Cy. In both of the models, the amylase and the secreted trypsinogen value were correlated. (r=0.596, r=0.640) The activated trypsin ratio among the whole secreted trypsinogen was different in each model. In P-Ch, the activation was very little in the samples with greater amount of whole secreted trypsinogen volume. On the other hand in the bile with small amount of secreted value, the activity was almost full. We concluded that the activation of trypsin and elastase in bile were proven in most of the canine models. And the activation values were changing, time to time. In bile with greater amount of secreted zymogen, the activation was always little. We suggested on the dangerous process in cyst-duodenostomy, according to the result of the experiment. Great amount of trypsinogen and other zymogen in bile would be explosively and completely activated by enterokinase drained from the duodenum, when the cyst-duodenostomy was performed.
日本小児外科学会の論文
1984-06-20

膵管胆道合流異常モデルの研究 : IV 胆汁内逆流膵蛋白分解酵素の活性化動態の検討

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