MODEL OF BILIARY PANCREATIC REFLUX

  • 1 January 1979
    • journal article
    • research article
    • Vol. 85  (2) , 147-153
Abstract
A primate model for the study of biliary pancreatic reflux under relatively physiological conditions is described. Cannulas were inserted into the gallbladder and the common bile duct of rhesus monkeys, and a pedicled segment of small bowel was used to create a pancreaticocutaneous fistula after resection of the spleen and pancreatic tail. Following recovery, Hypaque was instilled into the gallbladder with maintenance of common duct pressure within a normal range. The pancreatic duct was visualized in 21 of 34 radiographic studies (19 monkeys). Small amounts of I were detected in the fistula effluent of 9 of 11 animals that refluxed radiologically. Radioactive polyethylene glycol (PEG-14C) was instilled into the gallbladder, and pancreatic fistula drainage sampled by aspiration (26 studied, 4 monkeys). When compared to controls without PEG instillation (6 studies, 4 monkeys), there was a significant rise in fistula counts beginning 50 min after injection and peaking at 180 min. In a 2nd series of studies, pancreatic fistula aspiration was replaced by a flush technique using a triple-lumen cannula which allowed constant monitoring and control of fistula pressure. A statistically significant rise and fall of radioactivity after PEG introduction again was demonstrated. Biliary pancreatic reflux can occur and be quantitated under these experimental conditions.

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