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Cyclic motor activity of the gallbladder maintained in a pylorus-preserving gastrectomy in dogs
Authors:Akihito Enjoji  Kazuhide Ura  Kazuyuki Ozeki  Mikio Tsukamoto  Yoshito Ikematsu  Takashi Kanematsu
Affiliation:(1) Second Department of Surgery, Nagasaki University School of Medicine, 1-7-1 Sakamoto, 852 Nagasaki, Japan
Abstract:The gallbladder has cyclic motor activity (CMA), which is impaired after a conventional gastrectomy. We conducted experiments to determine whether or not a pylorus-preserving gastrectomy (PPG) could maintain gallbladder CMA. Six strain gauge force transducers were implanted into the gastrointestinal tract and gallbladder of six dogs, respectively. The motor activity of the gastrointestinal tract and gallbladder was recorded as a control. PPG was then carried out. The phasic contractions of the gallbladder, which were correlated with the antral contractions in the control state, were synchronized with contractions of the pylorus after PPG. Intravenous administration of CCK-OP (40 ng/kg) induced phasic contractions of the gallbladder at 4.6±0.2c/min in 3 of the 6 dogs with gastric contractions. After PPG, the gallbladder had phasic contractions (4.5±0.2c/m), which were synchronized with the contractions of the pylorus in all dogs regardless of the contractions in the remnant stomach. These findings suggest that gallbladder CMA has a closer relationship with the CMA of the pylorus than with the remnant stomach after PPG. Thus, a preservation of the pylorus at the time of gastric surgery will help in maintaining gallbladder function and coordination with the remnant stomach.Supported in part by grant no. 04670789 from the Ministry of Education, Japan.
Keywords:pylorus-preserving gastrectomy  gallbladder motility
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