THE ASSOCIATION BETWEEN ENTERIC BACTERIAL OVERGROWTH AND GASTROINTESTINAL MOTILITY AFTER SUBTOTAL LIVER RESECTION OR PORTAL-VEIN OBSTRUCTION IN RATS

Objective: To test the hypothesis that intestinal motility is delayed after hepatectomy, which alters the ecology of the enteric microflora and contributes to the development of bacterial translocation from the gut. Design: Open experimental study. Setting: University department of surgery. Material: Adult male Sprague-Dawley rats (n = 6 in each group at each time point). Interventions: Sham operation, 90% hepatectomy, and portal venous obstruction. Main outcome measures: Intestinal morphology, immunocytochemistry of the enteric nervous system, enteric bacterial growth in the small intestine and colon, and intestinal transit time. Results: Intestinal transit was already delayed one hour after 90% hepatectomy, and histopathological alterations and overgrowth by Escherichia Coli had developed after two hours. There were significant differences in intestinal transit time between sham operated rats and those subjected to portal venous obstruction on the one hand, and those that underwent 90% hepatectomy on the other. There was no difference in intestinal transit time between rats with portal venous obstruction and the sham operated animals. Conclusion: Delayed intestinal transit after 90% hepatectomy may contribute to enteric bacterial overgrowth and thereby contribute to the development of bacterial translocation from the gut.