Gastric function after pylorus-preserving duodenectomy in dogs.
OBJECTIVE
The purpose of this study was to delineate the alterations in gastric physiology after pylorus-preserving duodenectomy (PPD).


METHODS
The duodenum was transected 2 cm distal to the pyloric ring in five dogs. A patch graft around the papilla of Vater was preserved. Reconstruction was completed using an end-to-end duodenojejunostomy, anastomosis of the patch graft to the jejunum, and cholecystojejunostomy, in that order. Gastric acid analysis, serum gastrin and secretin concentrations, and gastric emptying were investigated before and one and three months after surgery.


RESULTS
The postoperative mean basal and maximal acid outputs were not significantly increased. Fasting serum gastrin concentrations remained unchanged. The fasting serum secretin concentrations one month after surgery increased significantly as compared to the controls. There were no significant differences in meal-stimulated gastrin or secretin responses or gastric emptying after surgery.


CONCLUSIONS
The acid output and gut hormone release after PPD were maintained at preoperative levels. Preservation of the duodenal bulb is postulated to be responsible for the maintenance of near-normal gastric physiology.
Kurita
N
N
First Department of Surgery, University of Tokushima School of Medicine, Japan.
Wada
D
D
Harada
M
M
Kawasaki
H
H
Tashiro
S
S
D000818:Animals; D002452:Cell Count; D004285:Dogs; D004386:Duodenum / Q000601:surgery*; D005744:Gastric Acid / Q000378:metabolism; D005746:Gastric Emptying; D019863:Gastrin-Secreting Cells / Q000473:pathology; D005755:Gastrins / Q000097:blood; D016577:Pancreaticoduodenectomy / Q000379:methods*; D010295:Parietal Cells, Gastric / Q000473:pathology; D011708:Pylorus / Q000502:physiology; D012633:Secretin / Q000097:blood; D013270:Stomach / Q000502:physiology*
D005755:Gastrins; D012633:Secretin