title: Functional characteristics of the pylorus in patients undergoing pylorus--preserving gastrectomy for early gastric cancer.
abstract: BACKGROUND
  This study investigates the functional characteristics of the pylorus in patients undergoing pylorus-preserving gastrectomy (PPG) for early gastric cancer.
  
  
  METHODS
  In study 1, postprandial symptoms and gastric emptying were compared between 2 groups of 12 patients with early gastric cancer more than 1 year after either PPG (PPG group) or distal gastrectomy (DG) (DG group). Gastric emptying was evaluated with the dual isotope technique for liquids and solids separately. In study 2, pyloric motility was evaluated with a sleeve/sidehole manometric assembly in 7 patients undergoing PPG, which was compared with that in the preoperative patients.
  
  
  RESULTS
  In study 1, the overall modified Visick score of postprandial symptoms and the Sigstad dumping score were significantly lower in the PPG group compared with the DG group (P <.05). Early accelerated gastric emptying was observed in both groups for liquids, but only in the DG group for solids. In study 2, isolated pyloric pressure waves induced by intraduodenal lipid infusion and phase III-like activity induced by intravenous erythromycin infusion were preserved after PPG.
  
  
  CONCLUSIONS
  The quantitative analysis of postoperative symptoms revealed that PPG patients were associated with better clinical conditions than DG patients. The clinical benefits of PPG are considered to be based on the function of the preserved pylorus.
authors.affiliation: Department of Surgery, Osaka University Graduate School of Medicine, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nishikawa
authors.forename: Hisayoshi
authors.initials: H
authors.lastname: Kawahara
authors.forename: Takeyoshi
authors.initials: T
authors.lastname: Yumiba
authors.forename: Toshirou
authors.initials: T
authors.lastname: Nishida
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Inoue
authors.forename: Toshinori
authors.initials: T
authors.lastname: Ito
authors.forename: Hikaru
authors.initials: H
authors.lastname: Matsuda
mesh_terms: D000328:Adult; D004386:Duodenum; D004917:Erythromycin / Q000008:administration & dosage / Q000494:pharmacology; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005746:Gastric Emptying; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000494:pharmacology; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D007275:Injections, Intravenous; D007440:Intubation; D008055:Lipids / Q000008:administration & dosage / Q000494:pharmacology; D008297:Male; D008365:Manometry; D008875:Middle Aged; D019518:Postprandial Period; D011312:Pressure; D011708:Pylorus / Q000187:drug effects / Q000503:physiopathology*; D011877:Radionuclide Imaging; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D013997:Time Factors
chemical_list: D005765:Gastrointestinal Agents; D008055:Lipids; D004917:Erythromycin