BILIOENTEROSTOMY ENHANCES BILIARY CARCINOGENESIS IN HAMSTERS

The aim of this study was to examine whether the type of bilioenterost omy enhances biliary carcinogenesis in the hamster model. Syrian hamst ers were divided into the following groups; simple laparotomy (control group), cholecystoduodenostomy with dissection of the extrahepatic bi le duct on the distal end of the common duct (CDDB group) and cholecys toileostomy with dissection of the extrahepatic bile duct on the dista l end of the common duct (CIDB group). Following these procedures, all hamsters received N-nitrosobis(2-oxopropyl) amine, The diameter of th e extrahepatic bile duct and plasma levels of cholecystokinin (CCK) we re measured and the number of neoplastic lesions was counted microscop ically. Proliferative effect of the procedures on the biliary epitheli um was examined by proliferative cell nuclear antigen, In the CDDB gro up the extrahepatic bile duct was significantly dilated and carcinogen esis of the gall-bladder and extrahepatic bile ducts was enhanced, In the CIDB group the CCK bioactivity was stimulated and intrahepatic bil iary duct, but not gall bladder and extrahepatic bile duct, carcinogen esis was promoted more than that observed in the CDDB group. Prolifera tion of the biliary duct epithelium was enhanced in both the CDDB and CIDB groups, Cholecystoduodenostomy enhanced intra- and extrahepatic b ile duct carcinoma, whereas cholecystoileostomy promoted only intrahep atic bile duct carcinoma. Some factors in the intestinal juice seem to play a role in the promotion of biliary tract carcinoma.