迷走神経切離の胆嚢機能におよぼす影響

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  • The Effect of Vagotomy on Gallbladder Function.

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There is mounting evidence that gallstone formation after surgery for gastric cancer is caused by dysfunction of the gallbladder due to vagotomy. In order to evaluate the effect of vagotomy on gallbladder function, the author analyzed patients who underwent surgery for gastric cancer in our department and experimental models of guineapigs after vagotomy. The clinical study demonstrated that the postprandial contractile activity of the gallbladder was markedly impaired after gastrectomy with extended dissection of lymphnodes, which can not be performed with preservation of vagal innervation to the gallbladder. This finding emphasizes that vagotomy promotes the development of gallstone. In contrast, the physiological functioning of the gallbladder was well preserved after vagus-preserving gastrectomy. These results indicate that preservation of vagal innervation to the gallbladder may be highly significant in preventing the development of gallstone after surgery for gastric cancer. Vagotomy produced the formation of gallstone-like substance in the gallbladder in 27.5% of guinea pigs at 8 weeks after operation. The results of this study concerning the mechanism by which gallbladder function is regulated shows that the postpranidal contractile activity of the gallbladder may be mainly attributable to the vagus nerve. In addition, the author observed that vagotomy reduced the postprandial rhythmic contraction of the gallbladder in the experimental model of the guinea pig. These results led to the conclusion that vagotomy is critically involved in gallstone formation after surgery for gastric cancer.

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