title: Inhibitory remnant stomach motility by duodenal distention after B-I gastrectomy.
abstract: OBJECTIVE
  Although control of gastric motility is a highly regulated process, B-I gastrectomy causes accelerated gastric emptying. We found few reports so far concerned with the mechanical effect of balloon distention of the duodenum on the remnant stomach in B-I dogs.
  
  
  METHODS
  Four weeks after conventional distal gastrectomy with B-I reconstruction procedure, a balloon was inserted into the duodenum, and strain gauge force transducers (SGTs) were sutured onto the wall of the gastric remnant and duodenal serosa in beagles. After a two-week postoperative recovery period, gastro-duodenal motility was measured with SGTs prior to distention, during distention, and after evacuation of the balloon. The motility index (MI) was calculated every 30 minutes.
  
  
  RESULTS
  Upon duodenal distention with 4 mL of water, motility of gastric remnant was significantly inhibited, however, no reduction in duodenal MI was observed. The response was maintained for as long as duodenal distension continued. Ninety minutes after evacuation of the balloon, MI returned to predistension levels. Increased plasma levels of cholecystokinin (CCK) were observed upon distention of the duodenal balloon.
  
  
  CONCLUSIONS
  Motility of the remnant stomach in B-I dogs was inhibited by duodenal distension. Increased levels of plasma CCK during distention might play a role in this feedback mechanism.
authors.affiliation: Department of Academic Surgery (M9), Graduate School of Medicine, Chiba University, Chiba City, Chiba, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Hirayama
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Gunji
authors.forename: Shinichi
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Takehito
authors.initials: T
authors.lastname: Kaiho
authors.forename: Hideaki
authors.initials: H
authors.lastname: Shimada
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Matsubara
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nabeya
authors.forename: Taito
authors.initials: T
authors.lastname: Aoki
authors.forename: Susumu
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Takenori
authors.initials: T
authors.lastname: Ochiai
mesh_terms: D000818:Animals; D002404:Catheterization; D002766:Cholecystokinin / Q000097:blood; D004285:Dogs; D004386:Duodenum / Q000503:physiopathology*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005746:Gastric Emptying; D018530:Gastric Stump / Q000503:physiopathology*; D005769:Gastrointestinal Motility; D013997:Time Factors
chemical_list: D002766:Cholecystokinin