Abstract
Enzymatic (1) and gas chromatographic technics (2) for the quantification of bile acids developed in the past 10 years, have resulted in the publication of vast data on the composition of bile. Almost without exception, bile for these studies has been obtained under nonphysiologic conditions, e.g., single sampling of duodenal bile from fasting humans, collections from tubes in the common duct proximal to the sphincter of Oddi, or from chronic fistula preparations. However, interruption of the enterohepatic circulation changes the composition of bile (1), concentrations of the constituents of bile vary with sampling technics (2), and the volume, total solutes and percentage concentration of constituents vary throughout a 24-hr period (3). We have modified technics, first used by Dragstedt et al. (4) and later by Preshaw and Grossman (5), in studies of pancreatic secretion to develop a canine preparation which allows repeated sampling of bile from an intact enterohepatic circulation.
Figure 1 is a diagrammatical representation of the method we have used to construct a duodenal pouch containing the intact sphincter of Oddi, draining through a Gregory cannula (6) into the duodenum opposite a Thomas cannula (7) in the reconstituted duodenum and extending through the abdominal wall.
Surgical technic. The upper abdomen is opened through a right paramedian incision. Vessels between the duodenum and the pancreas are carefully ligated with fine silk to mobilize a segment of duodenum 1.5 cm distal and proximal to the point of entry of the common duct. After ligation of the accessory pancreatic duct the duodenum is transected at points 1 cm and 3 cm proximal to the main pancreatic duct. The Gregory cannula is passed through the antemesenteric wall of the duodenal segment and proximal and distal ends of the pouch are closed in 2 layers.
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