Pancreatic head resection with and without preservation of the duodenum: Different postoperative gastric motility

Naritomi, Gen; Tanaka, Masao; Matsubara, Hiroaki; Yokohata, Kazunori; Ogawa, Yoshiaki; Chijiiwa, Kazuo; Yamaguchi, Kohji

doi:10.1016/s0039-6060(96)80091-2

Cited by 67 publications

(66 citation statements)

References 14 publications

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“…The mechanisms of PGS following PD is similar to that after gastrectomy. The results of our observations suggest no significant direct relation of PGS following PCC with the types of gastric operations or the loss of gastric parasympathetic control, nor was it related to the patients' age or presence of hypoproteinemia or preoperative gastric outlet obstruction (Table 2), which, however, might be the factors contributing to PGS after gastrectomy or PD [1][2][3][4][5] . We therefore suggest that the mechanism of PGS after PCC may differ, at least partially, from that underlying the PGS following gastrectomy or PD.…”

Section: Discussionmentioning

confidence: 99%

“…An identified cause for PGS has not been available, nor is its mechanism quite clarified. PGS after gastrectomy or pancreatoduodenectomy (PD) has been reported in a number of literatures [1][2][3][4][5] . Based on the results of clinical investigations [6][7][8][9] , cryosurgery targeting at the pancreaticoduodenal region was considered safe and effective for unresectable pancreatic cancer.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of multiple factors of postsurgical gastroparesis syndrome after pancreaticoduodenectomy and cryotherapy for pancreatic cancer

Dong

Li²,

Guan³

et al. 2004

WJG

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AIM:To explore the etiology, pathogenesis, diagnosis, and treatment of postsurgical gastroparesis syndrome (PGS) after pancreatic cancer cryotherapy (PCC) or pancreaticoduodenectomy (PD), and to analyze the correlation between the multiple factors and PGS caused by the operations. METHODS:Clinical data of 210 patients undergoing PD and 46 undergoing PCC were analyzed retrospectively. RESULTS:There were 31 (67%, 31/46) patients suffering PGS in PCC group, including 29 with pancreatic head and uncinate tumors and 2 with pancreatic body and tail tumors. Ten patients (4.8%, 10/210) developed PGS in PD group, which had a significantly lower incidence of PGS than PCC group (χ = 145, P<0.001). In PCC group, 9 patients with PGS were managed with non-operative treatment (drugs, diet, nasogastric suction, etc.), and one received reoperation at the 16th day, but the symptoms were not relieved. In PD group, all the patients with PGS were managed with non-operative treatment. The PGS in patients undergoing PCC had close association with PCC, tumor location, but not with age, gender, obstructive jaundice, hypoproteinemia, preoperative gastric outlet obstruction and the type and number of gastric biliary tract operations. The mechanisms of PGS caused by PD were similar to those of PGS following gastrectomy. The damage to interstitial cells of Cajal might play a role in the pathogenesis of PGS after PCC, for which multiple factors were possibly responsible, including ischemic and neural injury to the antropyloric muscle and the duodenum after freezing of the pancreatico-duodenal regions or reduced circulating levels of motilin.CONCLUSION: PGS after PCC or PD is induced by multiple factors and the exact mechanisms, which might differ between these two operations, remain unknown. Radiography of the upper gastrointestinal tract and gastroscopy are main diagnostic modalities for PGS. Non-operative treatments are effective for PGS, and reoperation should be avoided in patients with PGS caused by PCC. Dong K, Li B, Guan QL, Huang T. Analysis of multiple factors of postsurgical gastroparesis syndrome after pancreaticoduodenectomy and cryotherapy for pancreatic cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Analysis of multiple factors of postsurgical gastroparesis syndrome after pancreaticoduodenectomy and cryotherapy for pancreatic cancer

Dong

Li²,

Guan³

et al. 2004

WJG

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“…Recently, Naritomi et al 13 demonstrated slower recovery of gastric phase III activity and lower plasma concentrations of motilin in patients who underwent PPPD than in those who underwent duodenum-preserving pancreatic head resection.…”

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confidence: 99%

Effect of Leucine 13-Motilin (KW5139) on Early Gastric Stasis After Pylorus-Preserving Pancreatoduodenectomy

et al. 1998

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“…[23][24][25] We previously showed slower recovery of gastric phase 3 and lower plasma motilin concentrations in patients after PPPD than in those after duodenum-preserving pancreas head resection, and we speculated that prolonged gastric stasis after PPPD might be attributable at least in part to delayed recovery of the housekeeping function of gastric phase 3 as a result of the low plasma motilin concentrations caused by resection of the duodenum. 6 In fact, exogenous administrations of motilin and erythromycin as a motilin agonist produced phase 3-like gastric contractions and reduced gastric juice output in the early period after PPPD. 7,8 Yeo et al 26 also showed that exogenous erythromycin accelerated gastric emptying and reduced the incidence of prolonged gastric stasis after PPPD.…”

Section: Discussionmentioning

confidence: 99%

“…6 -8 One possible explanation for the delayed recovery of gastric phase 3 after PPPD is considered to be the low plasma motilin concentrations caused by resection of the duodenum. 3,6 However, other causes except for motilin influencing delayed recovery of gastric phase 3 after PPPD have not been well documented.…”

Section: Discussionmentioning

confidence: 99%

Gastric Phase 3 Motility After Pylorus-Preserving Pancreatoduodenectomy

et al. 2002

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ObjectiveTo analyze factors affecting the recovery course of phase 3 activity of the gastric migrating motor complex after pyloruspreserving pancreatoduodenectomy (PPPD) and investigate effects of the recovery of gastric phase 3 on gastric emptying after feeding. Summary Background DataWhether early recovery of gastric phase 3 during fasting would predict early recovery of the fed-state gastric emptying function after PPPD has not been well documented. MethodsManometric recording from the gastric antrum was repeated at a weekly interval until the first appearance of gastric phase 3 in 57 patients after PPPD. Twenty-three clinical parameters were assessed as possible factors affecting the recovery course of gastric phase 3 by simple and multiple regression analyses. A gastric emptying study after feeding of a test meal was performed by the acetaminophen method and the values were compared between patients with and without gastric phase 3 after PPPD.

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Pancreatic head resection with and without preservation of the duodenum: Different postoperative gastric motility

Cited by 67 publications

References 14 publications

Analysis of multiple factors of postsurgical gastroparesis syndrome after pancreaticoduodenectomy and cryotherapy for pancreatic cancer

Analysis of multiple factors of postsurgical gastroparesis syndrome after pancreaticoduodenectomy and cryotherapy for pancreatic cancer

Effect of Leucine 13-Motilin (KW5139) on Early Gastric Stasis After Pylorus-Preserving Pancreatoduodenectomy

Gastric Phase 3 Motility After Pylorus-Preserving Pancreatoduodenectomy

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