The duodenojejunal junction and Treitz ligament in the regulation of duodenal emptying.

In chronic experiments in dogs the evacuatory and absorptive duodenal functions and the level of duodenogastric reflux (DGR) in sham-operated dogs and dogs with transected Treitz ligament (TL) and resected duodenojejunal junction (DJJ) were studied. The electrophysiologic characteristics of the antrum, duodenum, and DJJ in sham-operated dogs were examined. It was shown that there is a coordination of gastric and duodenal solid carbohydrate food emptying. The process of evacuation from both organs was characterized by three closely correlated phases, phase 2 of emptying being exponential. In the TL transection and DJJ resection groups the coordination of gastric and duodenal emptying disappeared. The rate of carbohydrate solid food evacuation from the duodenum decreased, on average, by 45.5% +/- 5.5% (P < 0.05); phase 2 of duodenal emptying became unexponential, and the level of DGR considerably increased. The rate of duodenal absorption of main organic chyme components increased significantly in most of the time intervals studied. Significantly higher amplitudes of slow waves and spike potentials were recorded from the DJJ than from the duodenum. We conclude that the DJJ and TL are possible regulators of duodenal emptying. The DJJ is probably a functional sphincter that provides coordinated activity of the stomach and duodenum.

[Regulatory role of duodenal evacuation activity in determination of the absorption rate of organic components of duodenal chyme]. / Regulatornaia rol' évakuatornoi aktivnosti dvenadtsatiperstnoi kishki v opredelenii tempa vsasyvaniia organicheskikh komponentov duodenal'nogo khimusa.

The effect of inhibited duodenal motor-evacuation on the rate of protein, glucose, and lipid absorption was studied in chronic experiments in 5 polyfistulous dogs. Evacuation was inhibited by division of Treitz's ligament (a model of duodenostasis). The results of the experiments are evidence of a considerable regulatory effect of chyme evacuation rate on the value of the flow of substances from the enteral medium into the blood. The evacuation rate is in inverse proportion to the adsorption rate.

[The dynamics of the evacuation of carbohydrate and fatty food from the stomach and duodenum]. / Dinamika évakuatsii iz zheludka i dvenadtsatiperstnoi kishki uglevodnoi i zhirovoi pishchi.

The dynamics of the duodenal chyme evacuation depended on the absolute quantity of the stomach-evacuated food in dogs. The evacuation of the carbohydrate food was exponential. Fat food was evacuated in equal portions from the stomach and duodenum. The carbohydrate and fat food evacuation from the stomach and duodenum seems to be highly coordinated.

[The role of the duodenojejunal junction in regulating the evacuatory function of the duodenum]. / Rol' duodeno-eiunal'nogo perekhoda v reguliatsii évakuatornoi funktsii dvenadtsatiperstnoi kishki.

Chronic experiment on dogs was performed to study the effect of duodenojejunal junction exclusion from the evacuatory process on dynamics of gastric and duodenal emptying of the carbohydrate and fatty food. It is established that in the case of exclusion of the duodenojejunal junction, the degree of coordination of gastric and duodenal emptying decreases, dynamics of chyme evacuation from the duodenum considerably changes. It is concluded that the duodenum is not a mere transporter of food coming from the stomach, but has its own regulation mechanisms represented by the duodenojejunal junction and the Treitz ligament.

[Intragastric blood flow in the etiology of duodenal ulcer--new aspects of surgical treatment]. / Vnutrizheludochnyi krovotok v étiologii iazvennoi bolezni dvenadtsatiperstnoi kishki--novye aspekty khirurgicheskogo lecheniia.

In the experiment on dogs and in patients with duodenal ulcer disease, it was established that the regulation of acid production besides the vagal nerves was mediated by the intragastric gastrin transport with the blood flow. A method of preoperative diagnosis of the intensity of intragastric blood flow permitting to define more accurately the indications for the choice of a method for surgical treatment has been developed. Supplementation of the selective proximal vagotomy with circular mucosectomy at the boundary between the antrum and body of a stomach enhances the effectiveness of operation due to reduction of the antral gastrin influence on the acid-producing zones of the stomach.

[Electric activity of the proximal part of the digestive tract in the normal state and after pyloroplasty and transsection of the ligament of Treitz in dogs]. / Elektricheskaia aktivnost' proksimal'noi chasti pishchevaritel'nogo kanala v norme, posle piloroplastiki i peresecheniia sviazki Treitsa u sobak.

It is shown that the normal amplitude-frequency characteristics of the duodenojejunal flexure differ from those of the duodenum. After pyloroplasty, the electrical activity of the antrum do not change. At the region of the duodenojejunal flexure, the intensification of the electrical activity, increase in the amplitude, frequency of the slow wave and peak potentials occur. Supplementation of pyloroplasty with transection of the Treitz ligament led to suppression of the electrical activity of the antrum and duodenojejunal flexure. A conclusion about the close functional interrelation between the pylorus and duodenojejunal junction has been drawn.

[The role of Treitz' ligament in regulating the evacuation of solid food from the duodenum]. / Rol' sviazki Treittsa v regulirovanii évakuatsii plotnoi pishc hi iz dvenadtsatiperstnoi kishki.

In the chronic experiments on dogs by means of modified method of multiple drainage of the intestinal fistulas, the effect of the Treitz ligament transection on dynamics of solid carbohydrate food evacuation from the duodenum was studied. It was established that in the norm, evacuation from the duodenum was submitted to exponential law and depended on absolute quantity of food evacuated from the stomach. After the Treitz ligament transection, the evacuation through intestine had a non-exponential character. The operation led to disturbance in co-ordination between evacuatory function of the stomach and that of duodenum, and also had the depressive effect on intestinal emptying. The conclusion is made of the functional role of the Treitz ligament as active regulator of solid food evacuation from the duodenum.

[Characteristics of the motor function of the proximal segment of the gastrointestinal tract]. / Osobennosti évakuatornoi funktsii proksimal'noi chasti zheludochno-kishechnogo trakta.

Dynamics of the solid carbohydrate food evacuation from the duodenum has been determined in chronic experiments on dogs using modified technique for multiple drainage of intestinal fistulas. It is established that dynamics of the duodenal chyme emptying depends on the absolute quantity of the stomach-evacuated food and includes three phases: increase in the evacuation rate, exponential phase and that of accelerated evacuation. The highest rate of the duodenal contents is observed in the period from the 90th to 210th minute after food intake, the lowest one--at the end of the digestive cycle. A conclusion is made concerning the high degree of coordination of the evacuatory stomach and duodenum function.

[The role of the duodenojejunal flexure in regulating the motor evacuatory function of the duodenum]. / Rol' dvenadtsatiperstno-toshchekishechnogo izgiba v reguliatsii motorno-évakuatornoi funktsii dvenadtsatiperstnoi kishki.

The authors studied the macro- and microstructure of the Treitz ligament and duodenojejunal flexure in 92 cadavers. The variants of the Treitz ligament diversion from the duodenojejunal flexure, its topographic anatomy are described. The effect of the Treitz ligament transection on evacuatory function of the duodenum in 3 dogs was studied. The authors consider the Treitz ligament and duodenojejunal flexure as a valve, which regulates the duodenal content emptying. The possible mechanisms of the duodenojejunal valve functioning are discussed.