Gastroduodenal Motility in Pylorus Preserving Gastrectomy

Tsuneo Kurasawa

First Department of Surgery, Juntendo University School of Medicine

To elucidate the significance of preserving the pyloric branch of the vagus nerve in pylorus preserving gastrectomy (PPG). We prepared 3 groups of dogs: a control with no treatment, a PPG group, and a group receiving PPG combined with truncal vagotomy (PPG-TV). Gastroduodenal motility and gastric emptying were observed in each group for comparative evaluation. During the fasting period, there was no significant difference in the gastroduodenal motility of the 3 groups. In the postprandial period, however, deterioration in the motility of the PPG-TV group was particularly notable, with a significant drop (p<0.05) in the motor activity of the pyloric ring compared with that of hte PPG group. The time required for reemergence of the postprandial interdigestive migrating contractions of the PPG-TV group was 358 minutes, which was significantly longer than the control and the PPG group (295 minutes, 319 minutes) respectively. In the gastric emptying test by the acetaminophenmethod, the delay in the PPG-TV group was again significant (p<0.05) in comparison with the other 2 groups. Pyloric branch vagotomy performed in association with PPG causes a postoperative deterioration gastroduodenal motility and a dalay in gastric emptying, indicating the importance of preservation of pyloric branch of the vagus nerve.

Key words
pylorus preserving gastrectomy, gastroduodenal motility, gastric emptying

Reprint requests
Tsuneo Kurasawa First Department of Surgery, Juntendo University School of Medicine
2-1-1 Hongou, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
July 10, 1996

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