Effect of distal subtotal gastrectomy with preservation of the celiac branch of the vagus nerve to gastrointestinal function: an experimental study in conscious dogs.
OBJECTIVE
To evaluate the effects of distal subtotal gastrectomy with preservation of the celiac branch of the vagus nerve on gastrointestinal function.


BACKGROUND
The operative procedure of distal subtotal gastrectomy with preservation of the celiac branch of the vagus nerve is now in the spotlight in Japan with the goal of finding a function-preserving surgical technique. However, there has been no analysis of the effect of this type of surgery on gastrointestinal function. In this article, we describe the results of a fundamental experiment on distal subtotal gastrectomy with preservation of the celiac branch of the vagus nerve.


METHODS
Twenty conscious dogs were divided into 2 groups, each subdivided into 2 groups of 5: a normal intact dog group (NG) divided into 2 groups, with preservation (PNG) and resection (RNG; these dogs were truncally vagotomized including transaction of the celiac branch) of the celiac branch, and a gastrectomy dog group (GG) divided into 2 groups, with preservation (PGG) and resection (RGG) of the celiac branch. The motility of the dogs was recorded using strain gauge force transducers. The effects of the preservation of the celiac branch of the vagus nerve on gastrointestinal motility, gastric emptying, and pancreatic insulin release were evaluated.


RESULTS
The motility index of gastrointestinal motility with preservation of the celiac branch was higher than the motility index with resection of the celiac branch in fasted and fed of NG and GG. In gastric emptying, significant differences were found between the PNG and RNG but not between the PGG and RGG. In the fasted state for 80 minutes of the PNG and PGG, the serum insulin concentration reached a peak during the early phase III at 20 minutes in the gastric body and the antrum.


CONCLUSIONS
This study has shown that it is effective to preserve the celiac branch of the vagus nerve for gastroduodenal motility, gastric emptying, and pancreatic insulin release after a gastrectomy.
Department of General Surgical Science and the 21st Century COE Program, Gunma University Graduate School of Medicine 3-39-22, Japan. hando@med.gunma-u.ac.jp
Hiroyuki
H
Ando
Erito
E
Mochiki
Tetsuro
T
Ohno
Norimichi
N
Kogure
Naritaka
N
Tanaka
Yuichi
Y
Tabe
Hitoshi
H
Kimura
Yoichi
Y
Kamiyama
Ryuusuke
R
Aihara
Toshihiro
T
Nakabayashi
Takayuki
T
Asao
Tohru
T
Aomori
Yukiyoshi
Y
Fujita
Hiroyuki
H
Kuwano
D000704:Analysis of Variance; D000818:Animals; D001786:Blood Glucose / Q000032:analysis; D004195:Disease Models, Animal; D004285:Dogs; D005743:Gastrectomy / Q000379:methods*; D005746:Gastric Emptying / Q000502:physiology*; D005769:Gastrointestinal Motility / Q000502:physiology*; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D018709:Statistics, Nonparametric; D014630:Vagus Nerve / Q000601:surgery
D001786:Blood Glucose; D007328:Insulin