title: Effect of the anastomosis-site after Billroth I gastrectomy on the motility of the remnant stomach.
abstract: OBJECTIVE
  Gastric emptying, in healthy individuals, is a highly regulated process, and plasma cholecystokinin plays a major role in its feedback regulation. However, the hormonal regulation of postprandial gastric emptying of the remnant stomach after distal gastrectomy with Billroth I reconstruction procedure has not been well described. The aim of this study is to characterize the gastroduodenal motility and gastric emptying of the two anastomosis-methods after Billroth I gastrectomy, while assessing the effect of cholecystokinin on the motility of the remnant stomach.
  
  
  METHODS
  Two types of anastomosis (end-to-end, side (posterior wall)-to-end) after Billroth I gastrectomy were measured with strain gauge force transducers, and evaluated as to gastroduodenal motility, gastric emptying, gastrointestinal hormones (cholecystokinin, gastrin), and blood glucose associated with food administration.
  
  
  RESULTS
  Remnant stomachs with side-to-end anastomosis showed superior motility as compared to those with end-to-end anastomosis. Plasma cholecystokinin was higher in the end-to-end anastomosis group. No differences as to gastric emptying, levels of plasma gastrin, or blood glucose were observed between the two groups.
  
  
  CONCLUSIONS
  Plasma cholecystokinin may explain the difference in motility index between the two groups.
authors.affiliation: Department of Academic Surgery (M9), Graduate School of Medicine, Chiba University, Chiba City, Chiba, Japan.
authors.forename: Takehito
authors.initials: T
authors.lastname: Kaiho
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Gunji
authors.forename: Nobuo
authors.initials: N
authors.lastname: Hirayama
authors.forename: Hideki
authors.initials: H
authors.lastname: Hayashi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Hideaki
authors.initials: H
authors.lastname: Shimada
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nabeya
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Matsubara
authors.forename: Susumu
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Takenori
authors.initials: T
authors.lastname: Ochiai
mesh_terms: D000818:Animals; D001786:Blood Glucose; D002766:Cholecystokinin / Q000097:blood; D004285:Dogs; D004386:Duodenum / Q000502:physiology*; D005743:Gastrectomy / Q000379:methods*; D005746:Gastric Emptying; D005763:Gastroenterostomy / Q000379:methods*; D005769:Gastrointestinal Motility
chemical_list: D001786:Blood Glucose; D002766:Cholecystokinin