Partial gastric resection for peptic ulcer--comparison of the effect of variant reconstructive procedures on gastric emptying, gastric acid secretion and gastrin release in the early postoperative period I. Roux-en-Y and Billroth-II gastroenteroanastomosis.
Fourteen patients subjected to partial gastric resection with vagotomy and a gastroenterostomy (Roux-en-Y, in 11 patients and of Billroth type-II in 3) underwent examinations of the gastric emptying (GE) of a radiolabelled solid meal, as well as of gastric acid and gastrin secretion before surgery and/or within 5.5 weeks postoperatively. The surgery resulted in a significant delay in GE-the median T1/2 nearly doubted from 77 min before to 151 min after the operation (p < 0.01). The GE pattern did not, however, change significantly, as reflected by a median curve shape parameter S amounting to 1.05 and 0.87 before and after the surgery, respectively. The Roux-en-Y reconstruction brought about a pronounced delay in GE with T1/2 exceeding the border of the mean T1/2 + 2SD of healthy controls in 7 (64%) out of 11 patients. On the other hand, no one of the B-II operated patients had a slowed GE. The basal and pentagastrin-stimulated gastric acid secretion was decreased by an average of 71% (from 6.2 +/- 0.7 to 1.8 +/- 0.6 mmol h-1, p < 0.001) and 82% (from 25.2 +/- 3.0 to 4.4 +/- 1.2 mmol h-1, p < 0.001), respectively. The surgery did not affect the fasting serum gastrin concentration (53.2 +/- 4.9 pre- vs 51.0 +/- 11.5 ng.l-1 postoperatively), whereas the postprandial gastrin release decreased significantly-AUC0-120: 9838 +/- 1377 ng.l-1 min before and 6863 +/- 1024 ng.l-1 min after the operation, p < 0.01.
Lukasiewicz
S
S
Department of General Surgery, District Multi-Specialty Hospital, Tychy, Poland.
Jonderko
K
K
D000328:Adult; D000713:Anastomosis, Roux-en-Y; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005744:Gastric Acid / Q000378:metabolism*; D005746:Gastric Emptying; D005755:Gastrins / Q000097:blood*; D005763:Gastroenterostomy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011184:Postoperative Period; D011877:Radionuclide Imaging; D015167:Vagotomy, Truncal
D005755:Gastrins