A Comparative Study on Gastric Emptying and Secretory Status in the Early Postoperative Period after Truncal Vagotomy with Two Pyloroplasty Variants Performed for Peptic Ulcer Disease : I. Cassimally Pyloroplasty

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Gastric emptying (GE) of a radiolabeled solid meal, gastric acid secretion and gastrin release were examined within a median of 15.5 days (range: 9 to 66) after surgery in 14 peptic ulcer patients subjected to truncal vagotomy with Cassimally pyloroplasty (VTP-Cas). A significant delay in GE was observed after VTP-Cas; the median slope of GE curves, K, decreased from 14.65 (range: 2.56 to 21.86) before to 4.05 (range: 0 to 11.67) min^<-1>・10^<-3> after the operation (p<0.002). The postoperative GE was significantly slower than in a group of 41 healthy controls (median K=9.09, range: 3.72 to 28.66min^<-1・10^>-3>, p<0.01 vs the VTP-Cas-operated patients), and was characterized by a biphasic pattern with a slowed second phase. VTP-Cas resulted in a reduction of the basal acid secretion by an average of 87% (from 9.5±3.4 to 1.2±0.2 mmol・h^<-1>, p<0.05), and the pentagastrinstimulated acid output by 72% (from 30.8±7.2 to 8.6±1.6 mmol・h^<-1>, p<0.05). The fasting serum gastrin concentration remained unchanged after VTP-Cas (68.2±10.8 pre- vs 67.3±9.4 ng・1^<-1> postoperatively), whereas a slight and statistically insignificant increase in the meal-induced gastrin release was found following the VTP-Cas-AUC_<0-120>: 10002±1298 pre- vs 11234±1422 ng・1^<-1> min postoperatively.
東海大学の論文