Acid Secretion Ability of Gastric Tube used for Reconstruction after Esophagectomy for Esophageal Carcinoma -24 Hour pH Monitoring Study-

Mitsuaki Hashimoto, Masayuki Imamura, Yutaka Shimada, Takayoshi Tobe

First Department of Surgery, Faculty of Medicine, Kyoto University

Thirty patients with esophageal carcinoma were subjected to 24-hour gastric pH monitoring. The intraluminal pH in the fundus and the antrum of the stomach was measured before surgery and in the gastric tube after esophagectomy. According to the pH frequency distribution curves, the patients were divided into four groups; type 1, high acidity; type2, intermediate; type 3, low acidity; and type 4, antral high acidity groups. Median pH values through the night (0 a.m.-6 a.m.) and during prandial and postprandial periods were different among the four groups. Median pH values at the fundus at night were low in the type 1 and type 2 groups. In the type 1 and type 2 groups, there was no significant difference in median pH values or in the length of the periods when the pH remained below 3 between the pre-and post-operative readings taken at the fundus during the night. On the other hand, in the type 1 and type 2 groups there was a significant inverse corelation between the duration of the periods with an antral pH below 3 and the fasting serum gastrin concentration during the night. These results suggest that the gastric tube maintains its ability to secrete acid after esophagectomy and that there is a negative feedback mechanism between gastrin secretion and antral pH.

Key words
resection of esophageal cancer, gastric tube, acid secretion, 24 hour pH monitoring

Reprint requests
Mitsuaki Hashimoto First Department of Surgery, Faculty of Medicine, Kyoto University
54-Shogoin Kawara-cho, Sakyo-ku, Kyoto, 606 JAPAN

Accepted
February 12, 1992

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