МОРФОЛОГИЧЕСКАЯ ОСНОВА «ИГРЫ» ОТЦОВСКОГО СОСОЧКА

Аннотация

This article provides information on the morphological basis of the "game" of the paternal papilla. Keywords: phater papilla, phater papilla ampulla, hepatic-pancreatic ampulla, large duodenal papilla ampulla МОРФОЛОГИЧЕСКАЯ ОСНОВА «ИГРЫ» ОТЦОВСКОГО СОСОЧКА Аннотация. В статье представлены сведения о морфологической основе «игры» отцовского сосочка. Ключевые слова: фатерный сосочек, ампула фатерного сосочка, печеночно- поджелудочная ампула, ампула большого сосочка двенадцатиперстной кишки. Purpose of the study. Morphological substantiation of the "game" of the phaternal papilla and the role of its muscular sheath in the secretion of pancreatic juice and bile into the duodenal cavity depending on the digestive activity of the latter. Material and methods of research. The organocomplex of the area of the large papilla of the duodenum of 7 dogs and 11 rabbits was studied by serial histotopographic sections stained by the methods of haematoxylin-eosin, Van-Gizon and Mallory. Results. It has been established that the muscular membranes of the duodenum and ampulla of the phaternal papilla are represented by a single morphofunctional system. The intrinsic sphincters of common bile and pancreatic ducts are formed by a longitudinal layer, and the mouth sphincters by a circular layer of duodenal muscular tissue. Separate bundles of smooth muscle tissue of the longitudinal layer pass into the wall of the ampulla of the phaternal papilla in a cosocircular direction. Conclusion. "Play" of the phaternal papilla is represented by rhythmic contractions of the muscular membrane of the duodenal wall and the ampulla of the phaternal papilla in complex at the moment of digestion. It allows bile and pancreatic juice to be secreted into the duodenal cavity in portions and rhythmically, depending on the periodic activity of the latter, at the moment of digestion. The functional significance of the rhythmic contraction of the muscle of the phater papilla (the large papilla of the duodenum), which is called by radiologists and surgeons as the "game" or dance of the phater papilla is important (1), for the evacuation of bile and pancreatic juice into the duodenal cavity, depending on the digestive activity of the latter. According to the physiological literature, the release of these digestive juices into the duodenal cavity is a thousandth of a second ahead of the arrival of chyme (3). This process is highly regulated, and strictly co-ordinated. There are many sphincters in the wall of extrahepatic bile ducts and pancreatic duct (sphincters of Oddi, Lutkens, Boyden, Mirizzi and own sphincters of common bile and pancreatic ducts). 1 27 6 International scientific journal ISSN: 2181-3906 «MODERN SCIENCE АND RESEARCH» 2024 VOLUME 3 / ISSUE 5 / UIF:8.2 / MODERNSCIENCE.UZ The co-ordinated and strictly interdependent work of these sphincters and its dependence on the digestive activity of the duodenum make the work of this part of the digestive tract very important and complex. Literature devoted to the study of comparative and surgical morphology of the phaternal papilla [2,4,7,9], as well as the ampulla of the phaternal papilla [4,6] is available. Separate works are devoted to the study of the muscular sheath of the phaternal papilla [5]. However, there are questions concerning the morphology of this zone that require further clarification. This, first of all, concerns the question of studying the morphological basis of the mechanism of "play" of the phaternal papilla, on which the secretion of bile and pancreatic juice into the duodenal cavity depends. Also the questions of interrelation of the muscular sheath of the ampulla of the phaternal papilla with such sheath of the duodenal wall are not completely clarified. There are different and sometimes opposite opinions (8-10) regarding the relationship of the muscular sheath of the phaternal papilla with such a sheath of the duodenal wall. Clarification of these questions is not only important for the physiology of biliary excretion, but it is of great importance for elucidation of pathogenesis of dyskinetic disorders of biliary excretion and dysfunction of sphincters of the terminal part of the common bile and pancreatic ducts. Taking into account the above-mentioned, we studied the morphology of the phaternal papilla and interrelations of its muscular sheath with such sheath of the duodenum. Material and Methods. We have studied the large nipple of duodenum in 7 dogs and 11 rabbits by the method of preparation of serial histotopographic sections. Eighteen organ complexes fixed in 12% neutral formalin were studied. A flap of the duodenal wall was cut from the place of the common bile and pancreatic ducts penetration into its wall to the lower border of the mouth of the ampulla of the phaternal papilla. Conducting of the material and pouring into paraffin was carried out according to the generally accepted technique. The weight of the material was "planted" in one block and serial histot