胃全摘術, Roux-en Y再建後の再建小腸運動と消化管ホルモン分泌動態に関する実験的研究

概要

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Motility of the reconstructed intestine and the secretion profile of gut hormones (gastrin and motilin) were experimentally examined in dogs receiving total gastrectomy with Roux-en Y reconstruction in the postprandial and fasting periods. The following results were obtained. (1) After total gastrectomy, motor activities of the reconstructed intestine increased immediately after feeding. A new interdigestive migrating contractions (IMC) appeared in the fasting periods in the ascending portion of the reconstructed jejunum. Abnormal migrations of IMC were frequently seen early after operation. (2) In the interdigestive pattern of the blind-loop duodenum, a reduction in phase I and III and, a prolongation in phase II and in the cycle of phase III appearance were observed compared with the control dog. (3) Motilin secretion has not decreased after feeding and, in the fasting periods, increased to coincide with IMC of the blind-loop duodenum. The newly appearing IMC of the ascending jejunum, however, wbre not accompanied by an increase in motilin secretion. In contrast, gastrin secretion was low with little fluctuation both in the postprandial and fasting periods. Based on these findings, it is considered that the motor disorders of the reconstructed intestine, the blind-loop duodenum and changes in gut hormone secretion are, at least partially, the causes of postoperative complaints after total gastrectomy.
日本平滑筋学会の論文
1997-04-30