Evaluation of Hepatobiliary Excretion and Enterobiliary Reflux in Rats with Biliary Obstruction Submitted to Bilioduodenal or Biliojejunal Anastomosis |
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Authors: | Robson Azevedo Dutra José Sebastião dos Santos Whemberton Martins de Araújo Marcus Vinicius Simões Aline Nazareth Paiva de Paixão-Becker Luciano Neder |
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Affiliation: | 1.Department of Surgery and Anatomy,University of S?o Paulo at Ribeir?o Preto School of Medicine,Ribeirao Preto,Brazil;2.Department of Internal Medicine,University of S?o Paulo at Ribeir?o Preto School of Medicine,Ribeirao Preto,Brazil;3.Department of Pathology,University of S?o Paulo at Ribeir?o Preto School of Medicine,Ribeirao Preto,Brazil |
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Abstract: | Bilioduodenal and biliojejunal anastomoses are effective for the treatment of biliary obstruction. The objective of this study was to compare the effects of these anastomoses on hepatobiliary excretion and enterobiliary reflux. Enterobiliary reflux and biliary excretion were evaluated respectively after oral administration of technetium (99mTc) in combination with sodium phytate and intravenous infusion of 99mTc with diisopropyl-iminodiacetic acid. Enterobiliary reflux occurred to an equal degree in the bilioduodenal and biliojejunal groups. Maximum hepatic activity time (Tmax) and radiotracer clearance half-time (T1/2) were similar in both groups. However, when compared with that found for the sham-operated group, Tmax, and T1/2 were higher in the biliojejunal group (P = 0.02 and P = 0.01, respectively). Histopathological analysis showed marked reduction in ductal proliferation in both groups. These data undermine the theoretical advantages attributed to biliojejunal anastomosis and further the understanding of the pathophysiology of cholangitis that occurs even with patent anastomosis. |
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Keywords: | Enterobiliary reflux Hepatobiliary excretion Biliary obstruction Bilioduodenal and biliojejunal anastomoses Scintigraphic study |
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