Electrophysiological and mechanical activity of the upper gastrointestinal tract after duodenoplasty or segmental resection of benign gastric outlet stenosis.
In an animal experimental study we examined the postoperative recovery of the motility of the upper gastrointestinal tract after operative treatment of a benign gastric outlet obstruction. At 45 Days after induction, a duodenal stenosis was resected in six dogs, and resolved by Finney's duodenoplasty in another six dogs. Fourteen days after segmental resection, the gastric emptying was faster [half evacuation time (T1/2) for semisolid food = 44.4 +/- 16.8 min] than following duodenoplasty [T1/2 = 56.8 +/- 25.3). Here motor migrating complexes (MMCs) started in the antrum and could be traced down to the jejunum. After segmental resection we recognized MMC only distal to the anastomosis. The duration of the whole MMC cycle (69.0 +/- 18.6 min) as well as of the single phases was significantly shorter in the resection group than after duodenoplasty (108.0 +/- 15.1 min). At 28 days after operation the differences in the electromyographic findings were smaller (82.0 +/- 15.1 min vs. 111.4 +/- 11.2 min), but still significant. Obviously humoral transmitters and the extrinsic neural system lead to good propagation of the MMC across the anastomosis, even before the intramural pathways are reestablished. Concerning the fast recovery of the motility of the upper gastrointestinal tract, duodenoplasty is superior to segmental duodenal resection.
Peiper
C
C
Surgical University Clinic of the RWTH Aachen, Germany.
Titkova
S M
SM
Polivoda
M
M
Anurov
M
M
Arlt
G
G
Ottinger
A P
AP
Schumpelick
V
V
D000818:Animals; D004285:Dogs; D004380:Duodenal Obstruction / Q000601:surgery; D004386:Duodenum / Q000601:surgery*; D004576:Electromyography; D005746:Gastric Emptying / Q000502:physiology; D017219:Gastric Outlet Obstruction / Q000601:surgery*; D005769:Gastrointestinal Motility / Q000502:physiology*; D007583:Jejunum / Q000502:physiology; D016065:Myoelectric Complex, Migrating / Q000502:physiology; D019651:Plastic Surgery Procedures; D013270:Stomach / Q000601:surgery*