Document Detail


Gastric acidity following pancreaticogastrostomy with pylorus-preserving pancreaticoduodenectomy.
MedLine Citation:
PMID:  10594209     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pancreaticogastrostomy (PG) has been reintroduced and employed occasionally as a useful alternative to pancreaticojejunostomy (PJ) after Whipple resection or pylorus-preserving pancreaticoduodenectomy (PPPD). Although the physiologic alteration in the stomach is important for the correlation between gastric and pancreatic functions, the actual intragastric pH profile after PG is still unclear. This study was conducted to investigate the physiologic changes in gastric pH and serum gastrin and secretin levels before and after PPPD reconstructed with PG (PPPD-PG) in humans. Twenty-four hour continuous intragastric pH and serum gastrin and secretin levels in the fasting state were examined in 25 patients who had undergone PPPD-PG. No peptic ulcer was detected after the operation. After PG, serum gastrin and secretin levels were unchanged. Twenty-four hour gastric pH monitoring revealed two distinct patterns during the nocturnal period before the operation: patients with acid-type secretion (n = 11) exhibited a persistent acid pH, whereas those with alkaline-type secretion (n = 14) had cyclic variations between an acid and an alkaline pH value. After PG, in both acid- and alkaline-type patients, median pH and percentages of time that the gastric pH was less than 4 (% pH < 4) and more than 6 (% pH > 6) did not change, and circadian pH patterns also remained unchanged. These results suggest that PPPD-PG has little influence on gastric acidity, and the neurohumoral relation between the stomach, duodenum, and pancreas is preserved after PG. Therefore, physiologically, PG can be recommended as a reconstructive procedure after PPPD.
Authors:
H Shinchi; S Takao; S Maenohara; T Aikou
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  24     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-01-11     Completed Date:  2000-01-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  86-90; discussion 90-1     Citation Subset:  IM    
Affiliation:
First Department of Surgery, Kagoshima University School of Medicine, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Circadian Rhythm
Female
Gastric Acid / chemistry*
Gastric Acidity Determination
Gastrins / blood
Gastrostomy*
Humans
Hydrogen-Ion Concentration
Male
Middle Aged
Pancreas / surgery*
Pancreaticoduodenectomy*
Postoperative Period
Pylorus / surgery*
Secretin / blood
Time Factors
Chemical
Reg. No./Substance:
0/Gastrins; 1393-25-5/Secretin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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