Validation of Nuclide Gastric Emptying Tests

VanDeventer, G.; Graham, L. Stephen; Thomson, Jane; Thomason, D. M.; Meyer, James H.

doi:10.1097/00003072-198109001-00024

Cited by 4 publications

(4 citation statements)

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“…It is evident that the discrepancy becomes higher as the energy of the meal increases. The calculated T50s using scintigraphy for liquid meals with the same energy load, as in this study, are comparable with those found in the literature (Elashoff et al 1982, VanDeventer et al 1983, Christian et al 1980. For interpretation of the shorter T50s given by EIE direct simple comparison of the data given by both methods was carried out.…”

Section: Resultssupporting

confidence: 90%

Physiological interpretation of electrical impedance epigastrography measurements

et al. 2002

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Measurement of the electrical impedance of the gastric region is carried out with the epigastrograph. This generates and applies alternating current around the abdominal area and measures the potential difference in order to determine the impedance externally, via electrodes. The change of epigastric impedance for a subject, given a meal after fasting, depends on the conductivity of the meal compared to the stomach and surrounding tissues. Typically a conductive meal has conductivity >7 mS cm(-1), non-conductive <2 mS cm(-1) and neutral about 4.5 mS cm(-1). Half-emptying times (T50s) from gastric emptying studies in volunteers using three test meals of 450 ml volume were obtained and found to be shorter than expected from the literature. The meals were a 10% glucose solution and two milk shakes of energy 1,300 kJ and 2,850 kJ, respectively. These electrical impedance epigastrography (EIE) measurements were carried out with scintigraphy. The T50 values of the latter were significantly longer. The direct comparison of the normalized experimental data obtained by both methods led to the concept that EIE measurements are mainly influenced by gastric secretion. Thus the EIE trace of a 'neutral' meal suggests the hypothesis that the volume of the meal is not the significant factor but is influenced by gastric acid secretions. Physiology of the gastric mucosa during the digestion of a meal and intragastric pH values also suggests this. Gastric function studies using EIE measurements may therefore reflect gastric ionic concentration rather than the volume of the contents of the stomach. In turn this could lead to the development of a non-invasive method for the continuous recording of gastric acid secretions.

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Section: Resultssupporting

confidence: 90%

Physiological interpretation of electrical impedance epigastrography measurements

et al. 2002

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“…We have not only attempted to standardize our examination technique but have also chosen a test design that simulates a normal meal in a seated position, enabling us to believe that our system is both reproducible and a natural stimulus for the digestion process after consumption of food. Correction for geometry and radionuclide decay has not been regarded as necessary because of the small size of the gastric pouches (12) and the short examination time (1 h) in relation to the half-life of technetium (6 h). The stability of the radioactive labelling of the food is naturally of great importance.…”

Section: Discussionmentioning

confidence: 99%

Gastric Emptying Rate after Gastric Bypass and Gastroplasty

Näslund

Beckman

1987

Scandinavian Journal of Gastroenterology

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Fifty-seven morbidly obese patients were randomized into two surgical treatment groups, gastric bypass (n = 29) and gastroplasty (n = 28). Studies of the gastric emptying with radionuclide-labelled food were performed preoperatively (12 patients) and postoperatively at 2 months (28 patients) and 12 months (49 patients). Pouch emptying after gastric bypass was slower at 2 months than at 12 months. After gastroplasty the emptying rate was the same at 2 and 12 months and the same as that of gastric bypass at 12 months. A statistically significant correlation between stoma diameter and emptying rate was seen 1 year after gastroplasty but not after gastric bypass. No correlation between emptying rate and weight loss was shown in either group. Differences in the mechanisms of action between these two methods are apparent and are discussed.

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“…A region of interest around the stomach was manually drawn, allowing measurement of counts in the region of interest and total abdomen. These counts were then corrected for down scatter, septal penetration, and decay using equations generated by previous phantom studies with the 2 isotopes [30]. In aStandard and pylorus denote patients undergoing either the standard or pylorus-preserving pancreaticoduodenectomy.…”

Section: Gastric Emptying Studiesmentioning

confidence: 99%

Long‐term evaluation of pylorus preservation during pancreaticoduodenectomy

et al. 1988

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Although pyloric preservation can be performed during pancreaticoduodenectomy without increased morbidity or mortality or decreased survival, the long-term benefit of this technique remains unproven. In this study, the functional status of patients recovered from pyloric-preserving pancreaticoduodenectomy was evaluated by comparing 6 long-term survivors of the standard Whipple procedure (1-7 years postoperative; mean. 4.7 yr) to a similar group of 6 patients recovered from pylorus preservation pancreaticoduodenectomy (1-7 years postoperative: mean. 3.0 yr/. All patients completed a questionnaire evaluating postgastrectomy symptoms. Fasting blood specimens were obtained for hematologic and biochemical analysis. Ten of the 12 patients then underwent endoscopy; perianastomotic and midgastric biopsies were graded for inflammation. Gastric emptying of both liquid and solid phases was measured with an isotopically-labeled meal. Gastric emptying data were compared between groups and also to a group of 7 normal controls studied previously using the same methodology. Analysis of questionnaire results and mean laboratory values revealed no significant differences between the 2 surgical groups. Serum carotene levels were low in most patients. Several patients demonstrated abnormal indices of iron homeostasis. No significant abnormalities were noted on endoscopic examinations and biopsy results did not differ between the 2 surgical groups. Liquid gastric emptying was significantly prolonged in patients following standard pancreaticoduodenectomy (h/2 = 98.3 -+ 26.2 min) as compared to pylorus preservation patients (h/2 = 37.5 _+ 10.9 min) or normal controls (tl/2 = 33.1 -+ 2.8 min~. We conclude that. in the long-term, pylorus preservation appears to be at least functionally equivalent to the standard pancreaticoduodenectomy. As such. we believe that pyloric preservation. obviating vagotomy and gastric resection, deserves consideration during pancreaticoduodenectomy.

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Validation of Nuclide Gastric Emptying Tests

Cited by 4 publications

References 0 publications

Physiological interpretation of electrical impedance epigastrography measurements

Physiological interpretation of electrical impedance epigastrography measurements

Gastric Emptying Rate after Gastric Bypass and Gastroplasty

Long‐term evaluation of pylorus preservation during pancreaticoduodenectomy

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