Abstract
Cholangitis after biliary reconstruction for congenital biliary atresia is a troublesome postoperative complication. In order to clarify its mechanism and the changes in intestinal movement after biliary reconstruction by Roux-en-Y anastomosis, we performed electromyographic (EMG) studies of the motility of the reconstructed intestine in dogs. Monitoring the basic electrical rhythm (BER) and migrating myoelectric complexes (MMC), EMG analysis was carried out. As most of the Y-loop MMCs were propagated smoothly to the anal side, according to the continuity of the intestine, the intestinal contents were transported without stagnation. These intestinal movements appear to be useful as a biliary drainage route and to prevent ascending cholangitis. A comparison of short- and long-term intestinal motility after biliary reconstruction showed adaptation of the intestinal movement following the procedure. The outflow of bile appeared to accelerate intestinal motility because of prolongation of the MMC interval in the duodenum and oral jejunum without bile flow.
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References
Bass P, Code CF, Lambert EH (1961) Motor and electric activity of the duodenum. Am J Physiol 201: 287–291
Brook I, Altman RP (1984) The significance of anaerobic bacteria in biliary tract infection after hepatic portoenterostomy for biliary atresia. Surgery 95: 281–283
Bueno L, Praddaude F, Ruckebusch Y (1979) Propagation of electrical spiking activity along the small intestine: intrinsic versus extrinsic neural influences. J Physiol (Lond) 292: 15–26
Carlson GM, Bedi BS, Code CF (1972) Mechanism of propagation of intestinal interdigestive myoelectric complex. Am J Physiol 222: 1027–1030
Diamant NE, Bortoff A (1969) Effects of transection on the intestinal slow-wave frequency gradient. Am J Physiol 216: 734–743
Itoh Z, Aizawa I, Takeuchi S (1981) Neural regulation of interdigestive motor activity in canine jejunum. Am J Physiol 240: G324-G330
Kasai M, Kimura S, Asakura Y (1968) Surgical treatment of biliary atresia. J Pediatr Surg 3: 665–675
Miyano T, Suruga K, Kimura K (1981) Suruga II procedure for preventing postoperative ascending cholangitis in biliary atresia. Jpn J Pediatr Surg 13: 745–748
Ohta M (1979) Congenital biliary atresia: Experimental investigation into cholangitis following operation. Niigata Med J 93: 116–131
Pearce EA, Wingate DL (1980) Myoelectric and absorptive activity in the transected canine small bowel. J Physiol (Lond) 302: 11P–12P
Reynolds M, Luck SR, Raffensperger JG (1985) The valued conduit prevents ascending cholangitis: follow-up. J Pediatr Surg 20: 696–702
Szurszewski JH (1969) A migrating electric complex of the canine small intestine. Am J Physiol 217: 1757–1763
Takakuwa K (1982) Effect of vagotomy on gastrointestinal myoelectric pattern of the conscious dog. Jpn J. Smooth Muscle Res 18: 19–38
Takano K, Iwafuchi M, Uchiyama M (1989) Studies on intestinal motility and mechanism of cholangitis after biliary reconstruction. J Pediatr Surg 24: 1225–1231
Tanaka T, Kondo Y, Arakawa K (1966) Slow wave in gastro-intestinal electromyogram. Jpn J Smooth Muscle Res 2: 85–92
Vantrappen GR, Peeters TL, Janssens J (1979) The secretary component of the interdigestive migrating motor complex in man. Scand J Gastroenterol 14: 663–667
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Yagi, M., Iwafuchi, M., Uchiyama, M. et al. Electromyographic study of the mechanism of postoperative cholangitis in congenital biliary atresia. Pediatr Surg Int 5, 433–436 (1990). https://doi.org/10.1007/BF00174343
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DOI: https://doi.org/10.1007/BF00174343