Effect of Pancreatic Juice on Absorptive Mechanism of the Gall Bladder

Abstract

Wolfer 1 showed that pancreatic juice injected into the gall bladder of the dog caused marked histologic changes in the wall of the viscus. The possibility of this being the cause of cholecystitis clinically was thoroughly discussed by him. The secretory pressure of the pancreas is much higher than that of the liver 2 and in case of blockage of the ampulla by stone, anatomic arrangements are such in a high percentage of human subjects that the gall bladder might fill with pancreatic secretions. 3 , 4

Our studies on 19 dogs were aimed to determine if the presence of pancreatic juice would affect the permeability of the gall bladder to the constituents of the bile, especially the bile acids. The pancreatic juice (kindly furnished by Dr. L. R. Dragstedt) was activated and contained about 1000 units. It was injected directly into the gall bladder by needle puncture in some cases, in others, through a ureteral catheter up the common and cystic duct. Four cc. were used. The duration of the experiments was 4 days. The results were as follows:

1. Pathological changes of mild degree were evident in the gall bladder wall in most cases. These, however, were not marked. The susceptibility of the dog's gall bladder to slight stasis and infective influences, as we have previously noted 5 is so marked that it would be hazardous to assert that the changes found were not due to the manipulations. 2. In some experiments the juice was Berkefeld filtered. In these experiments the pathological and chemical changes were much less than from the unfiltered juice. 3. The average cholesterol content of the bile was not reduced, but the concentration of bile acids was reduced to less than one-third of the values found in control experiments.