Houghton A D, Liepins P, Clarke S M, Mason R C
Department of Surgery, Guy's Hospital and Medical School, London, UK.
Br J Surg. 1994 Jan;81(1):75-80. doi: 10.1002/bjs.1800810125.
Solid and liquid gastric emptying studies were conducted in 61 male Wistar rats. In 20 animals a two-thirds Pólya-type gastric resection was performed and 21 had a similar resection with a 10-cm Roux-en-Y diversion. In nine of the Roux diversions truncal vagotomy was also carried out. Twenty animals acted as controls: ten unoperated and ten that received laparotomy only. Body-weight and gastric emptying were measured weekly for 4 weeks and monthly for 4 months after surgery. Animals subjected to gastrectomy revealed a weight loss of approximately 16 per cent after operation. Weight gain was slower after Roux reconstruction than after Pólya-type anastomosis and slowest in animals with vagotomy and Roux drainage (P < 0.05). Gastric emptying was unchanged in unoperated controls. Animals in which a laparotomy was performed had delayed solid and liquid emptying for the first 4 weeks after operation (P < 0.05). Following Pólya-type gastrectomy, liquid emptying was delayed for 4 months. Solid emptying was unchanged, with no evidence of the delay present in animals with a laparotomy. Animals subjected to Roux-en-Y diversion showed a greater delay in liquid emptying than those with a Pólya resection; solid emptying was also delayed (P < 0.05). Severe gastric retention of liquids and solids occurred in the early postoperative phase when vagotomy was added to the Roux diversion (P < 0.01). Emptying of solids adopted a relatively normal linear pattern after this initial retention. Emptying of liquids, however, remained abnormal, appearing to adopt a biphasic pattern.
对61只雄性Wistar大鼠进行了固体和液体胃排空研究。在20只动物中进行了三分之二的波利亚(Pólya)型胃切除术,21只进行了类似的切除术并加做了10厘米的 Roux-en-Y 转流术。在9例Roux转流术中还进行了迷走神经干切断术。20只动物作为对照:10只未手术,10只仅接受剖腹术。术后4周每周测量体重和胃排空情况,术后4个月每月测量一次。接受胃切除术的动物术后体重减轻约16%。Roux重建术后体重增加比波利亚型吻合术后慢,在迷走神经切断和Roux引流的动物中最慢(P<0.05)。未手术对照组的胃排空未发生变化。接受剖腹术的动物在术后前4周固体和液体排空延迟(P<0.05)。波利亚型胃切除术后,液体排空延迟4个月。固体排空未发生变化,没有剖腹术动物中出现的延迟迹象。接受Roux-en-Y转流术的动物液体排空延迟比波利亚切除术的动物更明显;固体排空也延迟(P<0.05)。当在Roux转流术基础上加做迷走神经切断术时,术后早期出现严重的液体和固体胃潴留(P<0.01)。在最初的潴留期过后,固体排空呈现相对正常的线性模式。然而,液体排空仍不正常,似乎呈现双相模式。