Mistiaen W, Van Hee R, Blockx P, Bortier H, Harrisson F
University of Antwerp, Dept. of Anatomy, Groenenborgerlaan 171 2020 Antwerp, Belgium.
Hepatogastroenterology. 2001 Jan-Feb;48(37):299-302.
BACKGROUND/AIMS: Gastric emptying rate for solid and for liquid test meals was investigated retrospectively in patients with longstanding epigastric distress after partial gastrectomy, either as primary treatment or after failure of vagotomy for peptic ulcer in order to find an explanation for the postoperative symptoms.
Radionuclide-labeled liquid and solid test meals were used to evaluate gastric emptying rate, at least one year after surgery.
The lag phase for liquid test meals disappeared in all operated patients. Partial gastrectomy usually lead to fast emptying but this resective procedure, if performed after vagotomy, lead to stasis in a significant number of patients. Gastric emptying rate for solids increased in only a few of these symptomatic patients. In most of them however, there was a normal to decreased emptying rate. If a vagotomy had preceded the resective procedure, gastric emptying rate decreased significantly.
In all these symptomatic patients, gastric emptying had been disturbed for at least one type of test meal. This makes investigation for both meals necessary, especially since there is a lack of correlation. Furthermore, if vagotomy fails to prevent ulcer recurrence, one should carefully consider all options before performing partial gastrectomy since gastric emptying rate after these consecutive procedures worsens considerably.
背景/目的：对部分胃切除术后长期存在上腹部不适的患者（无论是作为原发性治疗还是在迷走神经切断术治疗消化性溃疡失败后），回顾性研究固体和液体测试餐的胃排空率，以寻找术后症状的解释。
使用放射性核素标记的液体和固体测试餐评估术后至少一年的胃排空率。
所有接受手术的患者中液体测试餐的延迟期消失。部分胃切除术通常导致排空加快，但如果在迷走神经切断术后进行这种切除手术，会导致相当数量的患者出现胃潴留。这些有症状的患者中只有少数固体胃排空率增加。然而，在大多数患者中，排空率正常或降低。如果在切除手术前进行了迷走神经切断术，胃排空率会显著降低。
在所有这些有症状的患者中，至少一种测试餐的胃排空受到干扰。这使得对两种餐都进行检查很有必要，特别是因为两者之间缺乏相关性。此外，如果迷走神经切断术未能预防溃疡复发，在进行部分胃切除术前应仔细考虑所有选择，因为连续进行这些手术后胃排空率会显著恶化。
