AN EXPERIMENTAL STUDY OF THE EFFECT OF CHOLE-CYSTGASTROSTOMY ON GASTRIC ACIDITY.

It has been shown that small amounts of the digestive secretions normally present in the duodenum regurgitate into the stomach following operative anastomosis between the stomach and the upper intestinal tract. As the duodenal contents are alkaline in reaction this reflux is thought by many to result in a decrease in the acidity of the gastric contents. The purpose of the investigations reported here has been to determine the effect of bile on the acid chyme of the stomach. By means of a cholecystgastrostomy with ligation and division of the common bile duct in six dogs the bile was diverted from the duodenum into the stomach. The secretion of gastric juice and the acidity of the gastric contents throughout the period of digestion were followed before and after the anastomoses. For this purpose three of the dogs were provided with Pawlow stomach pouches. In the three remaining animals the test meals were recovered by using apomorphin injections. The results from the two series of experiments agree. They indicate, at least with a diet of meat and water, that bile when it is present in the stomach throughout the course of digestion has no appreciable effect on the acidity of the gastric contents. While the anastomosis of the gall bladder to the stomach occasioned some temporary anorexia and vomiting in two of the dogs, the four remaining animals bore the operation well. Three or four weeks subsequent to the operation the digestion and the nutrition appeared normal in each instance. Postmortem examinations revealed no pathological changes in the gastric mucosa.