Does selective vagotomy prevent delayed gastric emptying and altered myoelectric activity following Roux-en-Y gastrojejunostomy?
Delayed gastric emptying occurs frequently following Roux-en-Y gastrojejunostomy. The role of vagal denervation in the etiology of this "Roux-stasis syndrome" is controversial. This study evaluates the effect of selective vagotomy on gastric emptying and motility following Roux-en-Y. Four dogs underwent control gastric emptying studies. The animals then underwent selective vagotomy, antrectomy, and Billroth II gastrojejunostomy, with placement of serosal electrodes. Gastric emptying was assessed with simultaneous myoelectric recordings, and the animals were converted to Roux-en-Y, followed by repeat studies. Gastric emptying was unchanged following selective vagotomy, antrectomy, and Billroth II gastrojejunostomy (T 1/2: 132 +/- 18 min [SEM] versus 118 +/- 14 min control) but was markedly delayed following Roux-en-Y diversion (T 1/2: 286 +/- 44 min; p less than 0.01). All animals went into the fed pattern following Billroth II gastrojejunostomy (migrating myoelectric complex [MMC] interval: 326 +/- 6 min postprandial versus 92 +/- 5 min fasting; p less than 0.01), but no fed pattern was recognized in three of four animals following Roux-en-Y diversion (MMC interval: 68 +/- 12 min postprandial versus 62 +/- 1.5 min fasting; p = NS). In a canine model, selective vagotomy does not prevent delayed gastric emptying or myoelectric alterations following Roux-en-Y.
Hocking
M P
MP
Department of Surgery, University of Florida College of Medicine, Gainesville.
Carlson
R G
RG
Vogel
S B
SB
D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects; D000818:Animals; D004285:Dogs; D005746:Gastric Emptying / Q000502:physiology*; D005763:Gastroenterostomy / Q000009:adverse effects*; D005769:Gastrointestinal Motility / Q000502:physiology; D007582:Jejunostomy / Q000009:adverse effects; D008297:Male; D016065:Myoelectric Complex, Migrating / Q000502:physiology*; D011183:Postoperative Complications / Q000517:prevention & control; D014629:Vagotomy, Proximal Gastric; D014630:Vagus Nerve / Q000502:physiology