Recovery of Fasted and Fed Gastrointestinal Motility After Open Versus Laparoscopic Cholecystectomy in Dogs

Abstract

ObjectiveThe authors investigate the recovery of gastrointestinal motility in the fed and fasted state after laparoscopic and open cholecystectomy. Summary Background DataClinical recovery after laparoscopic cholecystectomy is known to be more rapid than after conventional open cholecystectomy. However, the actual effect of a laparoscopic approach on gastrointestinal motility, particularly fed-state motility, is not well investigated. MethodsLaparoscopic (LAP, n = 6) or open (OPEN, n = 6) cholecystectomy was performed in 12 dogs. Bipolar recording electrodes were placed on the antrum, small intestine, and the transverse and descending colon, and fasting myoelectric data were recorded after operation. Solid meal gastric emptying studies were performed before surgery and on postoperative days 1 and 2. Transit time studies were performed using 10 radiopaque markers. ResultsGastric emptying was significantly delayed in the OPEN group at 120 minutes on postoperative day 1 compared with pre-operative emptying (p < 0.05), but was not delayed on postoperative day 2. Gastric emptying was not delayed in the LAP group after operation. Transit time was the same between groups. Gastric dysrhythmias were more frequent on postoperative day 3 (p < 0.05) in the OPEN group. There were no significant differences in the presence, cycle length, or propagation velocity of the migrating motor complex on any postoperative day. Discrete or continuous electrical response activity in the colon was observed by postoperative day 1 in both groups. ConclusionsFed-state gastric motility is the only parameter for which laparoscopic cholecystectomy showed an improvement in postoperative recovery. Recovery of fasted gastrointestinal motility in dogs is equally rapid after either operation. 413

Gastric Phase 3 Motility After Pylorus-Preserving Pancreatoduodenectomy

“…There have been few reports describing the relationship between the recovery of fasted and fed-state gastric motility after surgery. Only two previous articles by Hotokezaka et al 15,16 showed that the presence of gastric myoelectric dysrhythmias during fasting did not accurately predict fed-state gastric emptying after abdominal surgery in dogs. This is the first study to analyze factors affecting the recovery course of gastric phase 3 after PPPD and to elucidate whether early recovery of gastric phase 3 would reflect the early improvement of the fed-state gastric emptying function to the normal level in patients after PPPD.…”

Alterations in colonic transit time after laparoscopic versus open cholecystectomy: a clinical study

“…One study by Hotokezaka et al showed that GI motility, in general, was less affected, following laparoscopic vs. open cholecystectomy in dogs, only in the fed state, while colonic transit time was not affected by either procedure [16]. In another study of 46 patients, undergoing laparoscopic or conventional cholecystectomy, Geng et al showed that the laparoscopic group had significantly shorter anorectum exhaust time and peristaltic sound recovery time [8].…”

Randomized Clinical Trial of Itopride for the Treatment of Postoperative Ileus after Laparoscopic Cholecystectomy

“…When compared to open procedures, laparoscopic surgical techniques were accompanied more rarely by inflammatory responses [18]. Applying these techniques, gastric emptying and fasted state of gastrointestinal motility were improved and the rate of POI was reduced [19]. The use of opioid-free or opioid-reduced analgesic regimens such as nonsteroidal anti-inflammatory drugs or other agents have been demonstrated to reduce POI [3].…”