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KMID : 0371320000590010046
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Journal of the Korean Surgical Society
2000 Volume.59 No. 1 p.46 ~ p.53
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Gastric-Emptying Patterns after Gastroduodenal Reconstruction -Preservation of the truncal vagus nerve-
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Abstract
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Purpose: Gastric emptying after a gastric resection has been studied in early gastric cancer. Most reports are retrospective and show that gastric emptying after gastroduodenal reconstruction is faster than normal. This study was designed to
evaluate
the gastric-emptying pattern after a gastroduodenal reconstruction with preservation of the truncal vagus nerve had been performed on a patient whose preoperative gastric-emptying time had been normal. Methods: From July 1996 to February 1998, we
performed a distal gastrectomy with gastroduodenal reconstruction with preservation of the truncal vagus nerve in 11 patients (9 patients with early gastric cancer, 1 patient with advanced gastric cancer, and 1 patient with high-grade dysplasia)
whose
preoperative gastric-emptying times was normal. To evaluate the gastric emptying after the gastrectomy and gastroduodenal reconstruction, we analyzed the lag time (when 10% of food is delivered to the duodenum), T1/2 (when 50% of food
is
delivered to the duodenum), and the residual food in the stomach after 100 minutes (%) by means of radionuclide scintigraphy using a single-head gamma camera after ingestion of an 99mTc-tin-colloid steamed egg. We defined the delayed
gastric
emptying as T1/2 longer than the mean of the preoperative value by 2 standard deviation. Results: Among the 11 patients with gastroduodenal reconstruction, gastric emptying was normal in 4 patients and delayed in 7 patients; only one
of
the
delayed cases has GI symptoms such as early satiety. There were no rapid gastric emptying cases. Conclusion: Rapid gastric emptying after gastroduodenal reconstruction with preservation of the truncal vagus nerve was rare.
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KEYWORD
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