腹腔镜胰十二指肠切除术患者围手术期血清胃泌素和胃动素水平变化及其与术后胃瘫的关系

目的 探讨行腹腔镜胰十二指肠切除术(laparoscopic pancreatoduodenectomy,LPD)患者围手术期血清胃泌素和胃动素水平变化,分析胃泌素和胃动素与LPD术后胃瘫的关系.方法 对2019年2月至2020年8月在南充市中心医院接受腹腔镜胰十二指肠切除术的32例患者资料进行回顾性分析,测定患者血清...

Changes of serum gastrin and motilin levels in the perioperative period of laparoscopic pancreaticoduodenectomy and the correlation with postoperative gastroparesis

Objective To investigate the levels of gastrin and motilin in the perioperative period of laparoscopic pancreaticoduodenectomy (LPD) and the correlation with postoperative gastroparesis. Methods Clinical data of 32 patiens treated with LPD in Nanchong Central Hospital between Feb. 2019 and Aug. 2020 were retrospectively analyzed. The serum gastrin and motilin before surgery and 1^st, 3^rd, 7^th day after LPD were detected. According to the occurrence of gastroparesis after LPD, patients were divided into gastroparesis group (5 cases) and non-gastroparesis group (27 cases). Levels of gastrin and motilin were compared between the two groups. Results The total levels of serum gastrin and motilin in all 32 cases were increased gradually before LPD and 1^st, 3^rd, 7^th day after LPD (P>0.05). Before LPD, levels of gastrin and motilin in gastroparesis group were both lower than those in non-gastroparesis group. In gastroparesis group, levels of gastrin decreased on the 1^st, 3^rd, 7^th day after LPD, Levels of gastrin decreased on the 1st day postoperation and increased to the level of preoperative. In non-gastroparesis group, levels of gastrin and motilin both increased after LPD. The gastrin levels in gastroparesis group before LPD and 1^st, 3^rd, 7^th day after LPD were (71.25±20.24)pg/mL, (64.26±19.88)pg/mL, (62.81±16.27)pg/mL and (63.45±22.34)pg/mL, and which in non-gastroparesis group were (128.78±37.54)pg/mL, (147.12±67.22)pg/mL, (179.25±48.67)pg/mL, (185.98±57.27)pg/mL respectively. There were statistical differences in overall comparison (F_group=39.040, P=0.002), change trend of (F_time=17.256, P= 0.026), and change amplitude of variation (F_interactive=11.275, P=0.031) between the two groups. The gastrin levels in gastroparesis group before LPD and 1^st, 3^rd, 7^th day after LPD were (164.90±16.98)pg/mL, (136.45±16.77)pg/mL, (165.70±39.36)pg/mL, (169.62±16.41)pg/mL, and which in non-gastroparesis group were (225.34±74.58)pg/mL, (277.17±117.45)pg/mL, (348.52±89.71)pg/mL, (338.28±84.27)pg/mL respectively. There were statistical differences in overall comparison (F_group=28.457, P=0.003), change trend of (F_time=19.248, P=0.021), and change amplitude of variation (F_interactive=13.623, P=0.027) between the two groups. Conclusion This study suggests that insufficient secretion of motilin and gastrin during perioperative period of LPD maybe the cause of gastroparesis syndrome.