Nakabayashi Toshihiro, Mochiki Erito, Garcia Moises, Haga Norihiro, Suzuki Tomoaki, Asao Takayuki, Kuwano Hiroyuki
First Department of Surgery, Faculty of Medicine, Gunma University, 3-39-22 Showa-machi, Maebashi 371-8511, Japan.
World J Surg. 2002 May;26(5):577-83. doi: 10.1007/s00268-001-0270-6. Epub 2002 Feb 19.
An attempt was made to examine gastropyloric motility after pylorus-preserving gastrectomy (PPG) and to determine the influence of the pyloric branch of the vagus nerve in the dog. Fifteen dogs were divided into three groups of five. PPG with preservation (PPPG) and resection of the pyloric branch of the vagus (RPPG) were performed, and controls were prepared. Interdigestive and digestive gastropyloroduodenal motility was recorded after a 2-week recovery period using strain-gauge force transducers (SG). Radiopaque markers (ROMs) were used to assess gastric emptying. No significant differences were found between PPPG and RPPG in terms of gastropyloroduodenal motility during either the interdigestive or the postprandial state. During phase III of the interdigestive state, pyloric relaxation correlated with contraction of the gastric body after both PPPG and RPPG. During the first month it was accompanied by tonic and phasic pyloric contractions after feeding and delayed gastric emptying in two groups. By the end of the first month these pyloric contractions had diminished, and the rate of gastric emptying was similar to that of the controls. We concluded that it is not necessary to preserve the pyloric branch of the vagus for gastropyloroduodenal motility after PPG. Gastric stasis during the early postoperative period is due to tonic and phasic contractions of the pylorus.
本研究旨在观察保留幽门胃切除术（PPG）后胃幽门部的运动情况，并确定迷走神经幽门支在犬类中的作用。将15只犬分为三组，每组5只。分别进行保留迷走神经幽门支的保留幽门胃切除术（PPPG）和切除迷走神经幽门支的保留幽门胃切除术（RPPG），并设置对照组。术后2周恢复后，使用应变片式力传感器（SG）记录消化间期和消化期胃幽门十二指肠的运动情况。使用不透X线标志物（ROMs）评估胃排空情况。在消化间期或餐后状态下，PPPG组和RPPG组在胃幽门十二指肠运动方面未发现显著差异。在消化间期的III期，PPPG组和RPPG组幽门松弛均与胃体收缩相关。在术后第一个月，两组进食后均伴有强直性和阶段性幽门收缩以及胃排空延迟。到第一个月末，这些幽门收缩减弱，胃排空率与对照组相似。我们得出结论，PPG术后胃幽门十二指肠运动无需保留迷走神经幽门支。术后早期胃潴留是由于幽门的强直性和阶段性收缩所致。
