Delayed Gastric Emptying of Liquids and Solids Following Roux-en-Y Billiary Diversion

Hocking, Michael P.; Vogel, Stephen B.; Falasca, C. A.; Woodward, Edward R.

doi:10.1097/00000658-198110000-00012

Cited by 80 publications

(23 citation statements)

References 19 publications

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“…Roux dogs emptied their stomachs after solid meal four times more slowly than control animals (17). Previously, these investigators also reported that Roux animals emptied more slowly than comparable dogs with Billroth II gastrojejunostomy, and indicated that the reason for the stasis lied in Roux limb motility changes (18). Hinder et al (19) have reported that the reason for the Roux stasis syndrome lied in the gastric remnant, while extensive gastric resection is an effective means to reduce symptoms and improve gastric emptying in selected patients with severe gastric stasis of solid food after the Roux-en-Y procedure.…”

Section: Discussionmentioning

confidence: 93%

In vitro motility changes in Roux limb after Roux-en-Y reconstructio

Doğan¹,

Ak²,

Koyuncu³

et al. 2014

BLL

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Abstract:Background: The aim of this study is to compare the motility of Roux limb with that of normal segment. Materials and methods: Rats were divided into 3 equal groups as control, Roux-en-Y (Group A) and Roux-en-Y with vagotomy (Group B). Only midline incision and manipulations were applied in control group. Following distal gastrectomy, Roux-en-Y reconstruction was applied in Group A, while vagotomy Roux-en-Y gastrojejunostomy was applied in Group B. Rats were sacrifi ced 1 month later by cervical dislocations under anesthesia. The obtained jejunal segments were cut into four equal parts. The bath was 37 °C warm while 95 % O2 and 5 % CO2 gases were supplied in 10 ml bicarbonate Krebs' solution. Results: KCl responses were similar in all three groups. Acetylcholine contraction responses in the vagotomy and non-vagotomy Roux-en-Y groups was higher than in those in control group signifi cantly (p < 0.05). This response in vagotomy Roux-en-Y group was also higher than that in non-vagotomy group (p < 0.05). The induced electrical fi eld stimulation contraction response in the vagotomy + Roux-en-Y group was lower than those in control group and non-vagotomy group (p < 0.05). Conclusions: These results show that muscarinic receptor density and/or function may increase after vagotomy and non-vagotomy group operation, and vagotomy may contribute to this increase. The decrease in electrical signal response in vagotomy Roux-en-Y group may depend on the decrease in acetylcholine oscillation from the cholinergic nerve ending (Tab. 1, Fig. 5, Ref. 25). Text in PDF www.elis.sk.

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Section: Discussionmentioning

confidence: 93%

In vitro motility changes in Roux limb after Roux-en-Y reconstructio

Doğan¹,

Ak²,

Koyuncu³

et al. 2014

BLL

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Section: Discussionunclassified

“…Roux-Syndrom gefolgt sein [4,6]. Urs/ichlich werden eine St6rung des interdigestiven myoelektrischen Komplexes bei ausgeschaltetem duodenalen Schrittmacher, die gest6rte Freisetzung motilit/itsregulatorischer Hormone des aus der Passage ausgeschlossenen Duodenums sowie die gastrointestinale Denervation durch eine zusfitzliche Vagotomie diskutiert [4,7,10]. Im standardisierten Tiermodell sollte analysiert werden, ob die Art der Passagerekonstruktion (Erhalt/Ausschaltung der Duodenalpassage; B-I-/Roux-Rekonstruktion) die Entleerung des resezierten Magens beeinflugt und welche Bedeutung der Lfinge der zur Roux-Rekonstruktion verwendeten Jejunumschlinge sowie einer Vagotomie nach Roux-Resektion zukommen.…”

Section: Discussionunclassified

“…Auch feste Nahrung wird nach Vagotomie dann schneller entleert, wenn sie gemeinsam mit Fliissigkeit aufgenommen wird [8]. Tierexperimentelle Befunde, wonach eine Vagotomie die Magenentleerung nach Roux-Rekonstruktion zusfitzlich hemmt [4], konnten von uns nicht bestfitigt werden. Das eigene Ergebnis mit individuell deutlich variierenden Entleerungszeiten entspricht eher szintigraphischen Analysen, wonach antrektomierte, vagotomierte Hunde mit Gastrojejunostomie nach Roux eine nicht uniforme Entleerung fester Nahrung aus dem Magen zeigten [10].…”

Section: Diskussionunclassified

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Magenentleerung nach Magenresektion mit und ohne erhaltene Duodenalpassage

Walgenbach

Junginger

Eißner

et al. 1991

Langenbecks Arch Chir

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On domestic pigs 2/3 gastrectomies with retention and elimination of the duodenal passage were carried out. Postprandial gastric emptying was measured scintigraphically for 4 h and compared with a control group (laparotomy only). For the semi-solid, 99mTc-labeled test meal delayed gastric emptying after elimination of the duodenal passage by Roux reconstruction could not be shown. There was no difference in gastric emptying between B-I and Roux-en-Y partial gastrectomy. Also alteration of the length of the jejunum loop from 40 to 20 cm after Roux-en-Y reconstruction had no influence on gastric emptying. Roux reconstruction (40 cm loop) in combination with truncal vagotomy led to a non-uniform gastric emptying, but there was a statistically proven acceleration compared with B-I resection. After 240 min the mean residual intragastric activity of the control group (n = 5) was 47.8%, 78.9% after B-I resection (n = 5), 59% after Roux reconstruction with 40 cm jejunal loop (n = 5), 38.1% after Roux reconstruction with 20 cm jejunal loop (n = 5) and 20.9% after Roux-en-Y (40 cm loop) with truncal vagotomy (n = 4).

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“…They advocated a radical reduction of the size of the gastric remnant to overcome these problems. Some years earlier Hocking et al [1981] found, in the dog, that subtotal gastrectomy with Roux-en-Y improved the delayed emptying caused by TV with BII and Roux-en-Y. In human patients, TV following BII resection delays gastric emptying in com parison to antrectomy only [Vogel et al, 1983[Vogel et al, , 1988].…”

Section: Discussionmentioning

confidence: 99%

Gastric Emptying after Gastric Surgery

Wittebol¹,

Haarman²,

Hoekstra³

et al. 1988

Dig Surg

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Almost any study upon the stomach will alter gastric motility and emptying. There are many reports on the effects of different operations on gastric or gastric remnant emptying, studied by a wide variety of methods. So the results are difficult to compare. The aim of this study was to investigate, with one standardized radionuclide technique, the effect of highly selective vagotomy, truncal vagotomy with pyloroplasty, partial gastrectomy (Billroth II), truncal vagotomy with partial gastrectomy (Billroth II) and subtotal gastrectomy with Roux-en-Y reconstruction on gastric emptying of semisolid and solid meals. Furthermore, the correlation between postoperative symptoms and emptying patterns are investigated in these patients. It is concluded from this study that, in patients with postprandial symptoms after gastric surgery, significant correlations exist between the emptying patterns of normal semisolid and solid meals and those symptoms. Symptoms appear to be more severe and intractable when any form of gastric resection is combined with vagotomy. Knowledge of the importance of gastric motility and emptying is essential for any surgeon involved in surgery of the stomach.

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Delayed Gastric Emptying of Liquids and Solids Following Roux-en-Y Billiary Diversion

Cited by 80 publications

References 19 publications

In vitro motility changes in Roux limb after Roux-en-Y reconstructio

In vitro motility changes in Roux limb after Roux-en-Y reconstructio

Magenentleerung nach Magenresektion mit und ohne erhaltene Duodenalpassage

Gastric Emptying after Gastric Surgery

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