Ileocecal Valve as Substitute for the Missing Pyloric Sphincter After Partial Distal Gastrectomy
| Autor: | Lukas Degen, Martin Siegemund, Michael Heberer, Jürg Metzger, Wolfgang Studer, Markus von Flüe, Felix Harder, Christoph Beglinger |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Colon medicine.medical_treatment Gastroenterology Random Allocation Ileocecal valve Gastrectomy Ileum Internal medicine Laparotomy medicine Animals Gastrointestinal Transit Pylorus Ileocecal Valve Gastric emptying business.industry Stomach digestive oral and skin physiology Anastomosis Roux-en-Y Glucose Tolerance Test Pyloric sphincter medicine.disease Small intestine Surgery medicine.anatomical_structure Gastric Emptying Advances in Surgical Technique Dumping Syndrome Swine Miniature Dumping syndrome business |
| Zdroj: | Annals of Surgery. 236:28-36 |
| ISSN: | 0003-4932 |
| Popis: | Objectives Accelerated gastric emptying (including dumping syndrome) occurs frequently after gastric resections, largely resulting from rapid entry of meal contents into the small intestine. The authors hypothesized that an ileocecal segment used as an interpositional graft placed between the remaining part of the stomach and the small intestine would slow down food transit and thus replace pyloric function. Methods Thirty Gottingen minipigs were randomized into three groups. Group 1: partial gastrectomy and Roux-en-Y reconstruction; Group 2: partial gastrectomy and ileocecal interpositional graft; and Group 3: sham laparotomy. Gastric emptying in the nonsedated animals was quantified using radioscintigraphy at 3 and 6 months postoperatively. The animals ingested 300 grams of soft food containing 99mTc labeled resin- pellets using a technique previously described. Data were analyzed using ANOVA. Results Three months postoperatively, the ileocecal group had a significantly prolonged gastric emptying time compared with the Roux-en-Y group, but gastric emptying time was also significantly faster compared to the control group (sham laparotomy). After 6 months no significant difference was seen between the ileocecal group and the controls, while emptying rates were still significantly faster in the Roux-en-Y group. Conclusions Reconstruction of the gastric reservoir with an ileocecal segment largely restores gastric emptying patterns of food in minipigs. Six months postoperatively, gastric emptying time is similar to that of controls, and significantly slower when compared with the group with Roux-en-Y reconstruction. These results suggest that the ileocecal interposition graft could offer specific advantages over current reconstruction procedures. |
| Databáze: | OpenAIRE |
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