| ObjectiveTo compare and clarify the effect of vagus nerve effect on gallbladder and sphincter of Oddi ( SO) motility, two operation methods of portal azygous disconnection ( PAD) were chosen. The vagus nerve was cut off in Hassab operation, and was remained in splenectomy and vena coronaria ventriculi emboliza-tion. 99mTc - EHIDA (99mTc - labeled diethyl acetyl acid anilide iminodiacetic acid scintigraphy) method was used to assess the motor function of gallbladder and SO.The change of hormones level of biliary motility were studied in pre - and post - operation patients with liver cirrhosis and portal hypertension who were operated with Hassab. Discussing the abnormal mechanism of biliary motility of patients with liver cirrhosis and the effect of vagus nerve during interdigestive phase on patients with liver cirrhosis.MethodsReagent and instrument1. Experiment reagent;99mTc: Provided by China Academy of Sciences Atomic Energy Research Establishment;EHIDA; Provided by China Academy of Sciences Atomic Energy Research Establishment;Medical alpha - cyanoacrylate monomer ( TH adhesive) : Provided by Guangzhou Medical Adhesive General Co. ;ENSURE: Provided by American Abbott Laboratories. 250ml standard solution contains ENSURE powder 50g, calorie 1046. OKJ, protein 14. 0% , fat-ness 31.5% , carbohydrate 54.5% ;radio - immunity kit: provided by Beijing Huaying Biotechnology Research Institute;normal sodium containing 0.2% BSA;EDTA-Na2;aprotinin;acetone;acetic aether - ether mix solution (3/1 V/V).2. Experiment instruments:Scintigraphy radionuclide imaging instrument is Hawkeye of GE company;high - speed refrigerated centifuge:Germany Heraeus Company Labofuge 400 R type;super - low temperature refrigerator: Germany Heraeus Company;air-condition; Japan Mitsubishi company KFR-34G/BPQ type;multi - tube Radioimmunoassay Counter; Zhongcheng mechanic electron technology Co. , DFM -96 type.Study of the motor function of gallbladder and SO pre - and post -PAD1 Experiment target;23 patients with portal hypertension (13 males and 10 females, average age of 51 years) were included in this study. They had hypersplenotrophy and certain degree of hypersplenia. The esophagogastric variceal was confirmed with gastroscope. No biliary abnormalities were found with ultrasonography. Hepatic function was classified as Child A level.2 Operation Methods;(1) Hassab group; 18 patients with portal hypertension (10 males and 8 females, average age'of 50 years) undergone splenectomy. Mutilate and ligate AtV from 6 cm upon cardia to upper 1/2 of greater and lesser curvature of stomach, then cut anterior and posterior trunk of vagus off when liberating inferior segment of esophagus.(2 ) vena coronaria ventriculi embolization group; 5 patients with portal hypertension (3 males and 2 females, average age of 53 years) were undergonesplenectomy and vena coronaria ventriculi embolization. The method was that vena coronaria ventriculi bole was dissected and ligated after splenectomy was performed, and then 8ml TH adhesive was injected in the side of head of ligature.3 Radioactive nuclide scintigraphy:On the 3rd day preoperative and 10th day postoperative, mTc - EHIDA 185 MBq was administered intravenously to the patients, scintigraphy was performed at 15 - seconds/frame. Standard fat meal ( ENSURE 250ml standard solution ) was administered after 30 min scintigraphy, 60 min after the fat meal, the dynamic imaging was done.4 Collection and analysis of data;(1) Gallbladder data collection and analysis: The region of interest (ROI) of gallbladder was drawn, and time - activity curve of ROI was established. The curve was analyzed by 7 parameters as follows:(D Radiocounting being injected 99mTc - EHIDA 30 min later ( GBRC 30min) ;(2) Emptying fraction (GBEF) ; (3)Emptying period ( GBEP) ; (4s Emptying rate (GBER) ; (D Latent period (GBLP) ;(? Latent period radiocounting increment (GBLI) ;(7) Latent period radiocounting increment rat...
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