Experimental study on duodenal food passage vs. non-duodenal food passage reconstruction

Abstract

Background:Our clinical data accumulated during 30 years of clinical practice at the Department of Gastroenterological Surgery, Tokai University, indicated the effectiveness of the Billroth 1 procedure that preserve duodenal food passage, as well as its suppressive effect on hepatic metastasis. Here, the effectiveness of food passage through the duodenum is examined via experiments using BALB/c mice. Methods:In the first phase, gastrojejunostomy was performed using BALB/c mice. In the second phase, by duodenum ligation or not, the non-duodenal passage and duodenal passage models, respectively, were created. Transplantable colon26 was transplanted into the spleen, and the number of hepatic metastases was examined. At the same time, Kupffer cells, NK cells, Th1 cytokines, and Th2 cytokines such as IL-12, INFγ, and IL-4 were measured in the sham operation mice. Results:(1) Hepatic metastasis was observed in 9 of 25 mice (36.0%) and 18 of 26 mice (69.2%) in the duodenum passage model and non-duodenum passage model, respectively (p = 0.017, RR = 4.000, 95%CI, 1.246-12.842), and the average numbers of metastasis were 0.76 and 3.12, respectively (p = 0.077). (2) No significant differences were observed in the number of Kupffer cells and NK activity, and the production of Th1 cytokines and Th2 cytokines between the two groups. Conclusion:It was considered that in non-duodenum passage reconstructive surgery that produced bacterial translocation due to the existence of a blind loop may have induced cytokine production, causing the activation of NK cells and leading eventually to hepatic metastasis.