THE INFLUENCE OF SPHINCTEROTOMY AND HEPATIC PLEXUS VAGOTOMY ON ASCENDING INFECTIONS OF THE BILIARY-TRACT - AN EXPERIMENTAL-STUDY IN DOGS

BACKGROUND/AIMS: Hypertonic dyskinesia of the sphincter of Oddi is an important factor in the pathogenesis of postcholecystectomy syndrome, and this condition is usually treated by endoscopic sphincterotomy. Ho wever, it has been demonstrated that the biliary tract may also be con t;aminated after sphincterotomy. In various experimental studies, it h as been established that the choledochal pressure decreases by a mean of 32% to 28% after hepatic plexus vagotomy. This experimental study w as performed to investigate whether hepatic plexus vagotomy and/or sph incterotomy result in contamination of the biliary tract. METHODOLOGY: Thirty street dogs were divided into three equal groups. The three gr oups underwent simple laparotomy, transduodenal papillotomy, hepatic p lexus vagotomy, respectively, and gallbladder bile samples were taken from all of them. Relaparotomy was performed after four weeks, and aga in, bile samples were taken from the gallbladder. All bile samples wer e examined microbiologically. RESULTS: Bacteria were not found in the first bile samples taken from the three groups. Bacteria were not foun d in the bile samples taken during the second surgery in the simple la parotomy and hepatic plexus vagotomy groups. However, both aerobic and anaerobic bacteria were found in the papillotomy group in seven of th e ten dogs. CONCLUSION: These results demonstrate that hepatic plexus vagotomy decreased choledochal pressure and did not cause contaminatio n of the biliary tract. It may be a treatment of choice to prevent pos tcholecystectomy syndrome resulting from sphincter of Oddi dysfunction .