胃膽囊吻合術의 實驗的 硏究 = Experimental Study on Cholecystogastrostomy

다국어 초록 (Multilingual Abstract)

Various operative procedures have been developed for the purpose of decompression of the biliary tracts and choice of a certain operative method depends on the nature of the lesions and local and general condition of the patient. Each procedure has its own advantages and shortco-mings.
The author performed cholecystogastrostomy for the purpose of biliary decompression in 8 experimental dogs, the 10th day after complete ligation of the common bile duct.
The hematologic pictures, biochemical changes in serum components, bacteriological findings of bile, reflux of gastric contents and histopathological findings of hepatobiliary system were observed through the experimentation.
The results obtained were as follows:
1. In the peripheral blood, leukocytosis and anemia were observed in the ligated common bile duct and cholecystogastrostomy groups.
2. Serum cholesterol, alkaline phosphatase activity, S-GOT, S-GPT and total bilirubin were remarkably elevated in the ligated common duct group but returned nearly to normal after cholecystogastrostomy had been performed. There were no remarkable changes in total serum protein, A/G ratio and thymol turbidity in the both ligated common duct and cholecystogastrostomy groups.
3. Bacteria could not be demonstrated in the bile of the both control and ligated common bile duct groups, but intestinal floras were demonstrated in every cases of cholecystogastrostomy group.
4. Slight stenosis of the cholecystogastrostomy stoma and regurgitation of gastric content into the gall bladder were observed in all cases of the cholecystogastrostomy group.
5. In the ligated common bile duct group, bile pigment deposit in the hepatic cells and Kupffer cell and formation of bile plugs in the bile canaliculi were seen remarkably in the centrilobular area. Above phenomena were remarkably decreased in the cholecystogastrostomy group. In the cholecystogastrostomy group, those inflammatory cells such as lymphocytes, histiocytes and neutrophils were observed in the walls of the gall bladder and common bile duct.

목차 (Table of Contents)

• Ⅰ. 緖論
• Ⅱ. 實驗材料 및 方法
• A. 實驗材料
• B. 手術方法
• C. 血液, 膽汁, 組織採取 및 檢査方法
• Ⅲ. 實驗成績
• A. 血液像
• B. 肝機能檢査
• C. 膽汁의 細菌學的檢査
• D. 胃膽囊吻合口의 口徑 및 腸內客物의 逆流
• E. 肝, 膽囊 및 胃의 病理組織學的 所見
• 1. 肉眼的所見
• 2. 組織學的所見
• a. 總輸膽管結紮群
• b. 胃膽囊吻合術群
• Ⅳ. 總括 및 考按
• Ⅴ. 結論
• 參考文獻