ACUTE PANCREATITIS BY LIGATION OF COMMON BILE AND PANCREATIC DUCT

In this study, the effect of common bile and pancreatic duct obstruction were evaluated in the devolepment of acute pancreatitis. Rats were divided into the following groups; group A: Sham ligation, group B: Ligation of common bile duct, group C: Common bile duct ligation in middle portion of pancreas, group D: Ligation of common bile-pancreatic duct (adjacent to the duodenal wall), group E: Duodenum ligation (proximal and distal). Their blood was collected for measurement of amylase, lactic dehydrogenase (LDH), C-reactive protein (CRP), bilirubin, alkaline phosphatase, calcium concentration at 6th and 36th hr after operation. The rats were killed at 36 hr. Each pancreas were excised, weighed and processed for histological examination, the severity of pancreatitis was evaluated. The severity of pancreatitis was significantly increased in group D compared to that in other groups. Amylase, LDH and CRP were found as biochemical markers in early period. We are considered that bile reflux into pancreatic ductal system and cholecystokinin play a role in the pathogenesis of bile and pancreatic duct obstruction-induced acute pancreatitis.

SAFRA VE PANKREATÝK KANAL OBSTRÜKSÝYONLARININ PANKREATÝT OLUÞUMUNA ETKÝSÝ

Bu çalýþmada pankreas ve safra yolu obstrüksiyonunun pankreatit oluþumuna etkisi araþtýrýldý. Sýçanlar sham grubu (A), ana safra kanalý (AÞK) ligasyonu (B), ASK'nýn pankreatik kýsmýn ortasýndan ligasyonu (C), ASK ve PK'ýn duodenuma açýldýðý noktadan ligasyonu (D) ve duodenumun proksimal ve distalinin ligasyonu (E) þeklinde 5 gruba ayrýldý. Sýçanlardan biliribin, alkalen fosfataz, kalsiyum, amilaz, laktik dehidrogenaz (LDH), C-reaktif protein (CRP) ölçümleri için 6. ve 36. saatlerde kan alýndý. Sýçanlar 36. saatte sakrifiye edilerek pankreaslarý eksize edildi, yaþ aðýrlýklarý tartýldý, histopatolojik olarak incelendi. Pankreatitin þiddeti D grubunda diðer gruplara göre anlamlý olarak yüksek bulundu. Sonuç olarak, pankreatit geliþen sýçanlarda amilazýn yanýnda LDH ve CRP'nin erken dönemde yüksek bulunmasýnýn spesifik olmamakla beraber akut pankreatit tanýsý konulmasýnda yararlý olacaðý düþünüldü. Pankreatik kanal içerisine safra reflüsünün ve kolesistokinin'in obstrüksiyonla meydana gelen akut pankreatitin patogenezinde önemli rol oynadýðý kanýsýna varýldý.