Objective To investigate the effects of highly selective vagotomy plus mucosal antrectomy (HSVMA) and highly selective vagotomy (HSV) alone on the functions of the gastric antrum. MethodsEighteen dogs and 48 patients with chronic duodenal ulcer were tested. The time of gastric emptying, antral myoelectric activity, antral pressure were measured 4-6 months after operation in 18 dogs which were randomized into the control, HSV and HSVMA groups. The gastric evacuation, frequency and amplitude of electrogastrography (EGG) were observed 4-6 months after operation in 48 patients who were randomly divided into HSV (20 patients) and HSVMA (28 patients) group, their preoperative values were considered as control group. ResultsIt was found by barium meal examinations that the shape of the stomach and duodenum was normal and gastric peristalsis was clearly visible in all the animals and patients of two postoperative groups. The beginning and ending time of gastric emptying were (5.0±0.06) min and (4.0±0.4) h respectively in the dogs of HSVMA group, which were similar to those of the dogs of control and HSV group (Pgt;0.05). The frequency of the antral myoelectric action potential was (3.11±0.65 ) cycles/min in the dogs of HSVMA group, the frequency of EGG was (3.25±0.75) cycles/min in the patients of HSVMA group, which were significantly lower than that of the dogs or patients of control and HSV group (P＜0.05). Injection of pentagastrin in dogs or taking meal in patients significantly increased the antral pressure or amplitude of EGG. Conclusion The motor function of the reconstructed antrum in the HSVMA group approaches the normal level despite a lower antral myoelectric frequency. It is believed that HSVMA will be a choice for the treatment of duodenal ulcer.
To observe the changes of antral motor function and electrogastrography of 12 dogs and 30 patients with duodenal ulcer after highly selective vagotomy and mucosal antrectomy.Results: in an empty stomach, the preoperative and postoperative antral pressure value of dogs was similar, but the antral action potential frequency of dogs was slower after operation than that before operation. After injection of pentagastrin, whether before or after operation, the antral pressure value and action potential frequency of dogs were similar in the two groups. In an empty stomach, the electrogastrography frequency of patietns with duodenal ulcer was decreased after operation than that before operation, but their value of electrogastrography was similar, and after taking food, their preoperative and postoperative value and frequency of electrogastrography were significantly higher than that before taking food. But, whether before or after operation, there wasn’t significant diffence in them.Conclusions: there wasn’t changes of antral motor function and electrogastrography in dogs and patients with duodenal ulcer after highly selective vagotomy and mucosal antrectomy.
To investigate the influence of biliary surgery on gastrointestinal motility, electrogastrography (EGG) and gastrointestinal manometry were performed in a series of 17 patients who underwent biliary operation. EGG was done in all the patients in preoperative day, the operative day and the first, second and third postoperative day for at least one hour. Gastrointestinal manometry was done in eight patients in the operative day and the first, second and third postoperative day for 4－5 hours. Recording and analysis of EGG and gastrointestinal manometry were done by computer. Results: as compared with the preoperative day, the percentage of EGG normal wave in the operative day was obviously lower (Ｐ＜0.001)，and percentage of EGG bradygastria and tachygastria was remarkable higher (Ｐ＜0.01). From the first postoperative day, EGG frequency became normal. The EGG power was obviously low after operation till the third postoperative day. After operation, MMC in upper jejunum was rarely recorded, and in the third part of duodenum was most often recorded. Duration of phase Ⅲ of MMC ranged from 4－7 min. Contractive power and area of phase Ⅲ of MMC in the third part of duodenum changed obviously (Ｐ＜0.01),and the other had no changes. Conclusion: there were good correspondence between EGG and gastric manometry. Postoperative gastrointestinal dysfunction of stomach may be mainly caused by its fast wave. There were obvious changes of gastroduodenojejunal MMC after surgery which suggested that postoperative gastrointestinal dysfuntion might be caused by abnormal MMC. Improving the recovery of MMC may shorten the duration of postoperative gastrointestinal dysfunction.