Inhibitory remnant stomach motility by duodenal distention after B-I gastrectomy.
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.
Hirayama
Nobuo
N
Department of Academic Surgery (M9), Graduate School of Medicine, Chiba University, Chiba City, Chiba, Japan.
Gunji
Yoshio
Y
Miyazaki
Shinichi
S
Kaiho
Takehito
T
Shimada
Hideaki
H
Matsubara
Hisahiro
H
Nabeya
Yoshihiro
Y
Aoki
Taito
T
Kobayashi
Susumu
S
Ochiai
Takenori
T
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
D002766:Cholecystokinin