| Impaired emptying of the retained distal stomach causes delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy. | |
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MedLine Citation:
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PMID: 17566824 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Delayed gastric emptying (DGE) is the major morbidity after pylorus-preserving pancreaticoduodenectomy (PPPD). Gastroscintigraphy was used to characterize food distribution in the proximal and distal stomach during emptying. PATIENTS AND METHODS: Between October 2000 and June 2003, 20 healthy volunteers and 23 PPPD patients underwent single-phase gastric emptying scintigraphy 14 days after surgery. Scintigraphic studies of the stomach were divided into proximal and distal regions, and the ratio of proximal to distal radiation counts (P/DR) was plotted. Momentary monitor-displayed images were compared to evaluate meal distribution during emptying. RESULTS: There were 21 eligible patients, 12 without symptoms of DGE (sDGE-) and 9 with symptoms of DGE (sDGE+). In healthy volunteers the mean P/DR value was maintained at a level of > or = 2.5, and momentary images showed dilated proximal and constricted distal stomach throughout meal emptying. In both the solid and liquid phase tests, the average P/DR value for sDGE- patients was slightly lower than that for healthy volunteers, and momentary images showed early emptying of the solid meal. The mean P/DR value for sDGE+ patients was abnormally low and remained constant throughout the assessment. Momentary images showed significant dilatation of the distal stomach, with constant full size. The odds ratio for the change in P/DR per minute decreased after surgery, especially in sDGE+ patients, indicating a loss of contractility of the distal stomach. At the 6-month follow-up, the P/DR values exhibited a normal decreasing trend but were lower for sDGE+ patients than for healthy volunteers. CONCLUSIONS: The P/DR curve provides new insight into normal and pathological gastric function. After surgery, temporary loss of contractility of the distal stomach causes symptoms of DGE. |
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Authors:
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Yan-Shen Shan; Yu-Hsiang Hsieh; Wei-Jen Yao; Mei-Ling Tsai; Pin-Wen Lin |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: World journal of surgery Volume: 31 ISSN: 0364-2313 ISO Abbreviation: World J Surg Publication Date: 2007 Aug |
Date Detail:
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Created Date: 2007-07-16 Completed Date: 2008-01-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704052 Medline TA: World J Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1606-15 Citation Subset: IM |
Affiliation:
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Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138, Sheng-Li Road, Tainan, 70428, Taiwan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Female Follow-Up Studies Food Gastric Emptying* Humans Male Middle Aged Odds Ratio Pancreaticoduodenectomy / adverse effects*, methods Pylorus* Stomach / physiopathology, radionuclide imaging* Stomach Diseases / etiology*, physiopathology Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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