毕罗一世保留幽门胰十二指肠切除术后胃排空延迟：术后时间及西沙必利的影响
Delayed gastric emptying after Billroth I pylorus-preserving pancreatoduodenectomy: effect of postoperative time and cisapride.
作者信息
Takeda T, Yoshida J, Tanaka M, Matsunaga H, Yamaguchi K, Chijiiwa K
机构信息
Department of Surgery I, Kyushu University Faculty of Medicine, Fukuoka, Japan.
出版信息
Ann Surg. 1999 Feb;229(2):223-9. doi: 10.1097/00000658-199902000-00010.
OBJECTIVE
To study the recovery course of gastric emptying after Billroth I pylorus-preserving pancreatoduodenectomy (PPPD) and therapeutic effects of cisapride.
METHODS
To examine gastric emptying, acetaminophen was given, admixed in a pasty liquid meal, to 16 patients undergoing PPPD before surgery and at 1, 3, 6, 9, and 12 months after surgery. Cisapride was given orally to 10 patients before they received the acetaminophen regimen. Electrogastrography was performed at 2 weeks to 1 month after surgery in eight patients and at 6 to 12 months after surgery in seven patients.
RESULTS
Gastric emptying was delayed but returned to the preoperative level by 6 months after surgery. Pretreatment with cisapride accelerated gastric emptying during months 1 to 6 but not during months 6 to 12 after surgery. Electrogastrography frequently showed tachygastria 2 weeks to 1 month after surgery, but seldom 6 to 12 months after surgery.
CONCLUSIONS
After Billroth I PPPD, gastric emptying is delayed but recovers by 6 months after surgery. Tachygastria may play a part in the pathogenesis of delayed gastric emptying, but it can be treated with cisapride.
目的
研究毕Ⅰ式保留幽门胰十二指肠切除术（PPPD）后胃排空的恢复过程及西沙必利的治疗效果。
方法
对16例行PPPD手术的患者，在术前及术后1、3、6、9和12个月时，给予混有对乙酰氨基酚的糊状流食以检测胃排空情况。10例患者在接受对乙酰氨基酚给药方案前口服西沙必利。8例患者在术后2周1个月行胃电图检查，7例患者在术后612个月行胃电图检查。
结果
胃排空延迟，但术后6个月恢复至术前水平。西沙必利预处理在术后1至6个月加速胃排空，但在术后6至12个月无效。胃电图检查显示术后2周1个月常出现快速胃动，而术后612个月很少出现。
结论
毕Ⅰ式PPPD术后胃排空延迟，但术后6个月恢复。快速胃动可能在胃排空延迟的发病机制中起作用，但可用西沙必利治疗。
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