The effects of omeprazole, a proton pump inhibitor, on early gastric stagnation after a pylorus-preserving pancreaticoduodenectomy: results of a randomized study.
OBJECTIVE
To determine the effects of Omeprazole, a proton pump inhibitor (PPI), on gastric stasis following a pylorus-preserving pancreatico-duodenectomy (PPPD) by means of a randomized trial of PPPD patients.


METHODS
Forty-two PPPD patients were randomly divided into two groups: Group 1 (n=24) received a PPI through a jejunal tube after PPPD, whereas Group 2 (n=18), serving as controls, received a saline solution through a jejunal tube and no medication after a PPPD. The daily volume and total acidity of the gastric juice, aspirated via nasogastric tube, were measured each day for 7 days following PPPD.


RESULTS
In Group 1 the mean daily aspirated volume of gastric juice was 160.2 ml, and the mean maximum volume was 222.8 ml on the first postoperative day. In Group 2, six patients were withdrawn from this study for therapy on the third or fourth postoperative day due to gastric bleeding and/or a large amount of excreted gastric juice (in excess of 2,000 ml). The mean daily aspirated volume of gastric juice in the remaining Group 2 patients was 787.4 ml, and the mean maximum volume was 1,039 ml on the third postoperative day. Gastric secretion was significantly lower in Group 1 (p<0.05). Further, the total acidity of the gastric juice was significantly lower in Group 1 than in Group 2 for each of the 7 postoperative days (p<0.05).


CONCLUSIONS
These results indicate that postoperative administration of a PPI significantly suppresses the volume and acidity of the gastric juice after PPPD.
First Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
N
N
Toyota
T
T
Takada
H
H
Yasuda
H
H
Amano
M
M
Yoshida
T
T
Isaka
H
H
Hijikata
K
K
Takada
D000368:Aged; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects; D005750:Gastric Juice / Q000378:metabolism; D018589:Gastroparesis / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use*; D016577:Pancreaticoduodenectomy; D011182:Postoperative Care; D054328:Proton Pump Inhibitors
D004791:Enzyme Inhibitors; D054328:Proton Pump Inhibitors; D009853:Omeprazole