Gastric phase 3 motility after pylorus-preserving pancreatoduodenectomy.
OBJECTIVE
To analyze factors affecting the recovery course of phase 3 activity of the gastric migrating motor complex after pylorus-preserving pancreatoduodenectomy (PPPD) and investigate effects of the recovery of gastric phase 3 on gastric emptying after feeding.


BACKGROUND
Whether early recovery of gastric phase 3 during fasting would predict early recovery of the fed-state gastric emptying function after PPPD has not been well documented.


METHODS
Manometric recording from the gastric antrum was repeated at a weekly interval until the first appearance of gastric phase 3 in 57 patients after PPPD. Twenty-three clinical parameters were assessed as possible factors affecting the recovery course of gastric phase 3 by simple and multiple regression analyses. A gastric emptying study after feeding of a test meal was performed by the acetaminophen method and the values were compared between patients with and without gastric phase 3 after PPPD.


RESULTS
The mean period before the first appearance of gastric phase 3 was 38 days. Among 23 parameters, only lymph node dissection along the hepatoduodenal ligament significantly delayed recovery of gastric phase 3 after PPPD by univariate and multivariate analyses. The presence or absence of gastric phase 3 in the early postoperative period did not influence gastric emptying after feeding in the intermediate period after PPPD.


CONCLUSIONS
Avoiding lymph node dissection along the hepatoduodenal ligament, if applicable, may contribute to early recovery of gastric phase 3 after PPPD. The recovery state of gastric phase 3 during fasting, however, is not necessarily consistent with the degree of improvement of gastric emptying after feeding.
Ohtsuka
Takao
T
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Takahata
Shunichi
S
Ohuchida
Jiro
J
Takeda
Torahiko
T
Matsunaga
Hiroaki
H
Yokohata
Kazunori
K
Yamaguchi
Koji
K
Chijiiwa
Kazuo
K
Tanaka
Masao
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004067:Digestive System Neoplasms / Q000601:surgery; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008365:Manometry; D008875:Middle Aged; D016065:Myoelectric Complex, Migrating; D016577:Pancreaticoduodenectomy / Q000379:methods; D011184:Postoperative Period