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Previous issue date: 2003 / A dilatacao da papila com balao esta sendo investigada como uma opcao no tratamento de calculos dos ductos biliares e tem sido utilizada na pratica clinica desde 1982, principalmente na ultima decada. A justificativa do procedimento estaria na eventual vantagem de preservar a funcao da papila duodenal maior. Entretanto, pouco e conhecido sobre os efeitos da dilatacao na funcao e estrutura da papila. Foram usados 20 caes machos sem raca definida, separando-os em dois grupos de 10 animais para comparar a dilatacao com a simulacao do procedimento. A dilatacao foi realizada apos laparotomia e duodenotomia, com balao de 8mm insuflado com pressao de 0,5atm durante 2 minutos. A avaliacao funcional foi realizada com a manometria computadorizada, culturas bacterianas de conteudo vesicular e exames bioquimicos (fosfatase alcalina e gamaglutamil transferase). Essas avaliacoes foram efetuadas antes e imediatamente apos o procedimento inicial, uma e quatro semanas apos a dilatacao ou a simulacao. A avaliacao histologica da papila foi realizada apos a ultima avaliacao funcional. A pressao basal na regiao da papila nos animais submetidos a dilatacao apresentou diminuicao de 19,9mmHg para 11,1 mmHg e foi significantemente menor que a pressao basal do grupo controle na ultima avaliacao (p<0,05). A bile vesicular apresentou contaminacao bacteriana em 70 por cento dos animais submetidos a dilatacao e em 20 por cento no grupo de animais controle na primeira semana de avaliacao, sendo essa diferenca significante (p<0,05). Nao houve diferenca significante nos testes bioquimicos. A analise histologica demonstrou processo inflamatorio cronico em 60 por cento dos animais do grupo dilatado e 80 por cento dos animais do grupo controle, nao sendo essa diferenca significante. Considerando a diminuicao da pressao basal e o aumento da contaminacao da bile vesicular e possivel concluir que a dilatacao compromete a funcao da papila pelo menos durante 4 semanas neste modelo animal / Papillary balloon dilation is under investigation as a treatment modality for bile duct stones and has been used in clinical practice since 1982, particularly during the last decade. It may have an advantage of preserving the papillary function, but little is known about papillary function or histology after dilation. Twenty mongrel male dogs were divided into two groups of 10 animals each in order to compare dilation with sham operation. After laparotomy and duodenotomy, papillary dilation was done by an 8 mm balloon under pressure of 0.5 atm during 2 minutes. The papillary function outcome was evaluated immediately after the first operation, one and four weeks after procedure by computerized manometry, gallbladder bile culture and biochemical tests (alkaline phosphatase and gamma-glutamyltransferase). The histologic outcome was evaluated after the last functional examination. The results showed that the papillary basal pressure decreased from 19.9 mmHg to 11.1 mmHg in the dilation group which was significantly greater decrease than the one observed in the sham group (p<0.05). Gallbladder bile culture positivity was greater in the dilation group compared to the sham group in the first week (70% vs. 20%; p< 0.05). No significant differences were detected on biochemical tests. Histologic examination revealed no differences in the rate of chronic inflammation in the dilation compared to the sham group (60% vs. 80%; p>0.05). Thus, based on both significant greater basal pressure decrease and galbladder bile contamination increase in the dilation group compared to the sham group, it may be concluded that dilation impairs the papillary function at least for four weeks in this animal model. / BV UNIFESP: Teses e dissertações
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.unifesp.br:11600/18561 |
| Date | January 2003 |
| Creators | Zavadinack Netto, Martin [UNIFESP] |
| Contributors | Universidade Federal de São Paulo (UNIFESP), Fagundes, Djalma José [UNIFESP] |
| Publisher | Universidade Federal de São Paulo (UNIFESP) |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | 50 p. |
| Source | reponame:Repositório Institucional da UNIFESP, instname:Universidade Federal de São Paulo, instacron:UNIFESP |
| Rights | info:eu-repo/semantics/openAccess |
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