[Changes in slow and fast electrical activity of the gastro-duodeno-jejunal junction after cholecystectomy in humans].
The re-establishment of regular gastrointestinal electrical activity (Migrating Myoelectrical Complex-MMC- and slow wave) after cholecystectomy for gallstones was investigated in six female patients (50-77 years) by means of serosal electrodes implanted in the wall of the antrum, duodenum and jejunum during surgery. Five hour recordings were made on the first, third and fifth postoperative days, in patients who were on a liquid diet. The recordings were made after a twelve hour fast. On the fifth postoperative day, a test meal (250 g yoghurt) was given to the patients ant its effects on electrical activity were monitored for 2 hours. Even though MMC were present on the first and third postoperative days, a detailed study of their origin, the length of the Phase 3 and the speed of gastro-jejunal propagation showed that there existed an inhibition of gastric MMC until the fifth postoperative day and that intestinal MMC was slower than normal until the third postoperative day. On the fifth postoperative day, gastric inhibition disappeared since the length of the Phase 3 of the MMC of the stomach corresponds to those of the duodenum and jejunum, and the speed of propagation corresponded to that in normal subjects. Further, the slow wave frequency peculiar to each segment studied increased progressively from the first to the fifth postoperative day and the same was true of the slow waves with superimposed action potentials. In conclusion, notwithstanding the presence of MMC from the first postoperative day, it was only on the fifth day that normal coordination was restored and hence that patients were able to eat again.
Lemaire
M C
MC
Laboratoire de Physiologie, CHU Tours, France.
Riezzo
G
G
Pezzolla
F
F
Thouvenot
J
J
Giorgio
I
I
D000200:Action Potentials / Q000502:physiology; D000368:Aged; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000601:surgery; D004386:Duodenum / Q000502:physiology*; D004435:Eating; D005215:Fasting; D005260:Female; D006801:Humans; D007583:Jejunum / Q000502:physiology*; D008875:Middle Aged; D016065:Myoelectric Complex, Migrating / Q000502:physiology*; D010528:Peristalsis; D011182:Postoperative Care; D011706:Pyloric Antrum / Q000502:physiology*; D014839:Vomiting / Q000503:physiopathology