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TDK conference 2008

Effect of enteral tube placement on gallbladder function in dogs
Szilvási Viktória - year 5
Department and Clinic of Internal Medicine
Supervisors: Dr. Roland Psáder, Dr. Ágnes Sterczer


The jejunal feeding plays an important role both in human and dogs in several gastroenterological diseases, like in the treatment of acute pancreatitis. The endoscopically guided nasojejunal feeding tube - described first by us in dogs - opens new aspects in the enteral nutrition. Advantage of the method against the percutan jejunal feeding tubes, that it is a fast, non-invasive procedure, with only minimal complications. As a result of our previous studies we have established a new technique for the rutin measurement of the gallbladder volume (GBV) by ultrasound method. The aim of our study was to examine that the cholagouge drug (Lipofundin infusion) applied through the enteral tube how influences the volume of the gallbladder depending on the location of the tube.

In 5 healthy beagle dogs the fasting basic gallbladder volume was measured by ultrasound method. Then under full anaesthesia, an endoscopically-guided enteral feeding tube was placed into the jejunum, after fixation of the tube the location was controlled by X-ray. 2 ml/kg Lipofundin infusion was applied through the tube and its cholagouge effect was monitored by measuring the GBV in each 5th minute during 60 minutes. Subsequent this tube was flashed by physiological NaCl solution (2ml/minute) and checked the fill up of the gallbladder. Then the tube was pulled back first to the end of duodenum and jejunum, then to the end of duodenum descendens, and the steps prescribed above were repeated, subsequent the repeated fill up of the gallbladder. After finishing of the examinations (still on the same day) the tube was removed under anaesthesia. In all dogs all the examinations were made on different days. Another day the effect of orally applied (2 ml/kg) Lipofundin infusion in respect of gallbladder volume was also checked in all above dogs. The Lipofundin infusion given through feeding tube caused in jejunum 9,2 % (3.7-13.9), at duodeno-jejunal curve 16,5 % (9.1-22.1), in duodenum descendens 26,3 % (22.8-29.5) gallbladder contraction, while the cholagouge preparation given through the mouth caused 33.8 % (28.6-46.5) gallbladder contraction. The gallbladder contraction was the most significant between 10-30 minutes subsequent the Lipofundin feeding. According to our research the tube can be placed by endoscope to the jejunum (to 45-60 cm from the pylorus). The cholagouge preparation given through the feeding tube caused the smallest gallbladder contraction in the jejunum, while the most significant gallbladder contraction was in the duodenum. It can be concluded that the endoscopically guided nasojejunal tube is a viable option for dogs requiring post duodenal feeding, among others having pancreatitis, in which patients the feeding tube should be placed into the jejunum.

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