Effect of the anastomosis-site after Billroth I gastrectomy on the motility of the remnant stomach.
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.
Kaiho
Takehito
T
Department of Academic Surgery (M9), Graduate School of Medicine, Chiba University, Chiba City, Chiba, Japan.
Gunji
Yoshio
Y
Hirayama
Nobuo
N
Hayashi
Hideki
H
Miyazaki
Shinichi
S
Shimada
Hideaki
H
Nabeya
Yoshihiro
Y
Matsubara
Hisahiro
H
Kobayashi
Susumu
S
Ochiai
Takenori
T
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
D001786:Blood Glucose; D002766:Cholecystokinin