Effect of the anastomosis-site after Billroth I gastrectomy on the motility of the remnant stomach |
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Authors: | Kaiho Takehito Gunji Yoshio Hirayama Nobuo Hayashi Hideki Miyazaki Shinichi Shimada Hideaki Nabeya Yoshihiro Matsubara Hisahiro Kobayashi Susumu Ochiai Takenori |
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Institution: | Department of Academic Surgery (M9), Graduate School of Medicine, Chiba University, Chiba City, Chiba, Japan. |
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Abstract: | BACKGROUND/AIMS: Gastric emptying, in healthy individuals, is a highly regulated process, and plasma cholecystokinin plays a major role in its feedback regulation. However, the hormonal regulation of postprandial gastric emptying of the remnant stomach after distal gastrectomy with Billroth I reconstruction procedure has not been well described. The aim of this study is to characterize the gastroduodenal motility and gastric emptying of the two anastomosis-methods after Billroth I gastrectomy, while assessing the effect of cholecystokinin on the motility of the remnant stomach. METHODOLOGY: Two types of anastomosis (end-to-end, side (posterior wall)-to-end) after Billroth I gastrectomy were measured with strain gauge force transducers, and evaluated as to gastroduodenal motility, gastric emptying, gastrointestinal hormones (cholecystokinin, gastrin), and blood glucose associated with food administration. RESULTS: Remnant stomachs with side-to-end anastomosis showed superior motility as compared to those with end-to-end anastomosis. Plasma cholecystokinin was higher in the end-to-end anastomosis group. No differences as to gastric emptying, levels of plasma gastrin, or blood glucose were observed between the two groups. CONCLUSIONS: Plasma cholecystokinin may explain the difference in motility index between the two groups. |
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