Changes of the Gastric Motility after Pylorus Preserving Pancreaticoduodenectomy.
- Author:
Jong Kwon PARK
1
;
Jung Jin SEO
;
Ho Jin JUN
;
Min CHUNG
;
Dong Guk PARK
;
Jung Taik KIM
;
Chang Young LIM
;
Seok Gun PARK
Author Information
1. Department of Surgery, College of Medicine, Dankook University.
- Publication Type:Original Article
- Keywords:
Gastric emptying time;
Pylorus preserving pancreaticoduodenectomy
- MeSH:
Colloids;
Duodenum;
Electrodes;
Esophageal pH Monitoring;
Esophageal Sphincter, Lower;
Esophagus;
Gastric Emptying;
Gastroesophageal Reflux;
Healthy Volunteers;
Humans;
Hydrogen-Ion Concentration;
Meals;
Motor Activity;
Ovum;
Pancreaticoduodenectomy*;
Postoperative Period;
Pyloric Antrum;
Pylorus*;
Skin;
Stomach
- From:Journal of the Korean Surgical Society
1999;56(4):522-531
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: To evaluate delayed gastric emptying after a pylorus-preserving pancreaticoduodenectomy, we studied gastric motility in 11 normal volunteers and 11 patients who had undergone a pylorus-preserving pancreaticoduodenectomy. Additionally, the 24 hour esophageal Ph recordings were examined to evaluate gastroesophageal reflux after a pylorus-preserving pancreaticoduodenectomy. METHODS: Gastric motility was evaluated by using the gastric-emptying time and electrogastrograms. The gastric-emptying time was measured using a solid meal containing 99mTc-tin colloid. The half gastric-emptying time (GET1/2) was defined as the half time (T1/2) of the fall of gastric isotopic activity from the peak. Electrogastrogram (EGG) signals were detected from the surface electrodes on the skin overlying the gastric antrum. The 24-hour esophageal Ph was monitored by using a nasoesophageal probe placed in the distal esophagus 5 cm above the lower esophageal sphincter. RESULTS: In our study, the normal volunteers showed a 99+/-35 minute half gastric-emptying time. The patients were divided into two groups by a time of 2 months after the operation, early and late postoperative groups. Delayed gastric emptying after a pylorus-preserving pancreaticoduodenectomy in the early postoperative period (272+/-176 minutes) was normalized in the late period (106+/-37 minutes), p=0.020. Abnormal early EGG patterns also normalized in the late postoperative period. There was no significant difference of total Ph<4-time % between patients in the early (0.1+/-0.1%) and the late postoperative periods (0.4+/-0.4%), p=0.064. CONCLUSIONS: It is supposed that anatomical and functional preservation of the stomach and the proximal part of the duodenum after a pylorus-preserving pancreaticoduodenectomy enabled gastric motor activity to be normal in the late postoperative period.