J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 979KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 96(1): 1-9, 1995

Original article

THE MECHANISM OF DEVELOPMENT OF ACUTE GASTRIC ULCERATION FOLLOWING BILIARY DRAINAGE IN OBSTRUCTIVE JAUNDICE

The First Department of Surgery , Kobe University School of Medicine, Kobe, Japan

Hitoshi Moritomo, Yoshi Nagahata, Tomoaki Urakawa, Yoichi Saitoh

Upper gastrointestial hemorrhage occurs occasionally in the time of surgery or biliary infection in patietns with obstructive jaundice. In the present study, the influence of obstructive jaundice and biliary drainage on the rat gastric mucosa was examined.
Serum t-Bil, GOT and Alp increased during obstructive jaundice, but decreased following biliary drainage. Hexose and fucose levels in gastric mucosa decreased during obstructive jaundice ; both of them increased in the 1- and 2-week jaundiced groups, however, neither increased in the 3-week jaundiced group following biliary drainage.
Prolonged obstructive jaundice demonstrated a marked increase of ulcer index (UI) and decrease of gastric mucosal blood flow (BF) following water immersion and restraint stress. Biliary drainage induced these changes in the 1- and 2-week jaundiced groups, but induced neither of these changes towards recovery in the 3-week jaundice group.
Prostaglandin (PG) E2 induced significant decrease in isolated gastric vascular perfusion pressure in the 2-week jaundiced group ; it did not, however, have this effect in the 3-week jaundiced group.
In conclusion, it was speculated that differences between the 3-week and 2-week jaundiced groups were present in sensitivity to PGE2 in the gastric vascular system, and that different reactions of the gastric microcirculation resulted in different changes in the gastric mucosal state following biliary drainage.

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