Roux-en-Y duodenojejunostomy improves gastric emptying in experimental obstruction of the distal duodenum

Autor: Joanna Kołodziejczak-Nalewajka, Paweł Lampe, Katarzyna Kuśnierz, Marek Olakowski, Zygmunt Górka, Anna Kasicka-Jonderko, Krzysztof Jonderko, Sławomir Mrowiec
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Cancer Treatment
lcsh:Medicine
Random Allocation
0302 clinical medicine
Medicine and Health Sciences
lcsh:Science
Mammals
Multidisciplinary
Stomach
Eukaryota
Roux-en-Y anastomosis
Bowel obstruction
Surgical Oncology
medicine.anatomical_structure
Oncology
Bypass surgery
030220 oncology & carcinogenesis
Vertebrates
030211 gastroenterology & hepatology
Anatomy
Research Article
Clinical Oncology
medicine.medical_specialty
Duodenum
Gastric Bypass
Surgical and Invasive Medical Procedures
Endocrine System
Anastomosis
Digestive System Procedures
03 medical and health sciences
Stomach surgery
Dogs
Exocrine Glands
medicine
Animals
Pancreas
Gastric emptying
business.industry
lcsh:R
Organisms
Biology and Life Sciences
Anastomosis
Roux-en-Y
medicine.disease
Surgery
Gastrointestinal Tract
Gastric Emptying
Amniotes
lcsh:Q
Clinical Medicine
business
Digestive System
Zdroj: PLoS ONE, Vol 13, Iss 6, p e0199759 (2018)
PLoS ONE
ISSN: 1932-6203
Popis: Introduction We undertook a comparative survey of gastric emptying (GE) kinetics after two variants of bypass surgery for upper bowel obstruction. Material & methods In 10 dogs with experimental upper bowel obstruction, five were randomized to obtain gastrojejunal anastomosis (GA), and the other five received Roux-en-Y duodenojejunal anastomosis (DA). Duplicate scintigraphic measurements of GE of a solid meal were accomplished in every animal before surgery and during the early (2–3 weeks), medium (3 months), and late (6 months) post-operative period. The GE curves were fitted with a power-exponential function to derive the GE half time T½, and the curve shape parameter S. Results Early after surgery T½ slightly decreased by -18±21 min in the DA group and lengthened by 91±37 min in the GA group (p = 0.042). In both groups an increase in the S parameter was found then. In either group T½ gradually declined towards the basal value during the medium and late post-operative period. On the other hand, net differences relative to the basal situation in the S values appeared to be positive in the GA group (0.32±0.11 at 3 months; 0.64±0.19 at six months), and negative in the DA group (-0.30±0.09 at 3 months; -0.01±0.20 at six months). Hence a statistically significant contrast was found between those differences: p = 0.0022 at 3 months, and p = 0.045 at six months after the surgery. Conclusion Roux-en-Y duodenojejunal anastomosis appears to be superior to the classical gastrojejunal anastomosis while restoring patency of the gastrointestinal passage in the case of upper bowel obstruction.
Databáze: OpenAIRE
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