Gastric emptying following vagotomy and antrectomy and proximal gastric vagotomy.

Abstract

SUMMARY Gastric emptying of solid meals labelled with 129Cs was studied in patients for up to one year after vagotomy and antrectomy or after proximal gastric vagotomy. Significant delay was found one month after vagotomy and antrectomy but this had returned to normal by six months. No delay was found after proximal gastric vagotomy.The effect of posture on gastric emptying was also studied in the same subjects. No significant differences were found between gastric emptying in the supine or sitting positions after solid meals.The technique of monitoring clearance from the stomach of a meal containing a radioactive tracer has been widely used in recent years in patients with a variety of gastric disorders (Jones, Clark, Kocak, Cox, and Glass, 1970;Tinker, Kocak, Jones, Glass, and Cox, 1970; Colmer, Owen, and Shields, 1973; and van Dam, 1974). Early workers used external counters but the use of computerized gamma-camera systems is becoing more common (Cowley, Vernon, Jones, Glass, and Cox, 1972; Hancock, BowenJones, Dixon, Dymock, and Cowley, 1974).The recent study of van Dam (1974) indicates that the range of emptying rates is large in a group of normal subjects but that individuals appear to have characteristic and repeatable values. However, the effects on gastric emptying rates of a number of important variables remain to be fully resolved and there is no standard technique for the acquisition and presentation of data. This paper presents the results of a comparative study of the effects of truncal vagotomy and antrectomy and of proximal gastric vagotomy (Amdrup and Jensen, 1970;Johnston and Wilkinson, 1970) on gastric emptying. Emptying patterns have been investigated by comparison of measurements performed during the period from one month to one year following operation.Among the factors which may affect the results of such measurements are the character of the meal, the posture of the subject, the length of time of the observations, and the mode of presentation of the

Comparison of the Effect of Conventional Highly Selective Vagotomy and Anterior Gastric Wall Stapling with Posterior Truncal Vagotomy on the Gastric Emptying Rate for Solid Meals in Beagle Dogs

“…The early phase of gastric emptying for liquids may be fastened [8], possibly due to the loss of recep tive relaxation of the fundus [26,28]. On the other hand, temporary decrease in the gastric emptying rate after HSV has also been no ticed [12,18,25], The latter findings were present in our HSV-treated dogs: the gastric emptying rate decreased, however, not signifi cantly 2 weeks after the operation.…”

Post-surgical and obstructive gastroparesis

“…Although this is particularly true for fundoplication, it may also apply to procedures involving a vagotomy. This resolution of symptoms may also be accompanied by improvement in gastric emptying [26][27][28], suggesting that either the enteric nervous system may be able to adapt to loss of vagal input or that vagal reinnervation may occur, as shown for afferent (but not efferent) fibers in experimental models [29]. Regardless of the explanation, the physician should adopt a conservative, watchful, and cautiously optimistic approach when initially seeing a patient with new onset of PSG.…”

Effect of pyloroplasty on gastric emptying: Long term results as obtained with a labelled test meal 14–43 months after operation

“…A delay of solid meal emptying has been shown to occur in varying degrees at 1 week to 6 months after truncal vagotomy and pyloroplasty and truncal vagotomy and antrectomy (Cowley et al, 1972;Hancock et al, 1974;Howlett et al, 1974;Kalbasi et al, 1975;Donovan et al, 1976). This effect appears to be only temporary.…”