The effect of the anastomotic size on gastric emptying after hemigastrectomy with Billroth II reconstruction

Steven H. Tyndall, Muhammed Ashraf Memon, Richard J. Lund, David Beck, John Fessenden, Mary Ruth Stegman, Robert Joseph Fitzgibbons

Research output: Contribution to journalArticle

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Abstract

Objective. To determine if the size of the gastrojejunal anastomosis after Billroth II reconstruction was the rate-limiting factor in gastric emptying in the postoperative period. Methods. Twelve mongrel dogs were randomized to have either 1.5 cm or 5 cm gastrojejunal anastomoses prior to Billroth II hemigastrectomy. Each dog had three solid and three liquid radiolabelled emptying studies pre- and postoperatively. Data were collected using a gamma camera. For liquid studies, images were obtained at 0 min, 2 min, 4 min, 6 min, 8 min, 10 min, 20 min, 30 min, 40 min, 50 min and 60 min. For solid studies, images were obtained at 0 min, 5 min, 10 min, 20 min, 30 min, 40 min, 50 min, 60 min, 70 min, 80 min, 90 min, 100 min, 110 min and 120 min. Means were compared by analysis of variance using the repeated measures option. Results. Postoperative liquid emptying was significantly faster in the first 10 min with both 1.5 cm and 5 cm anastomoses compared with preoperative scans in the same animals (45% versus 20% and 48% versus 29%, respectively). On the other hand, solid gastric emptying was much slower postoperatively with the 1.5 cm anastomosis compared with preoperative scans (29% versus 65%) as well as compared with postoperative 5 cm anastomosis (29% versus 62%) at the end of 120 min. Conclusions. Our model suggests that the gastric emptying of solids is affected by the size of the gastrojejunal anastomosis and not by the diameter of the efferent limb of the small intestine following Billroth II reconstruction.

Original languageEnglish
Pages (from-to)1359-1364
Number of pages6
JournalEuropean Journal of Gastroenterology and Hepatology
Volume11
Issue number12
StatePublished - 1999

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Gastroenterostomy
Gastric Emptying
Dogs
Gamma Cameras
Postoperative Period
Small Intestine
Analysis of Variance
Extremities

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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The effect of the anastomotic size on gastric emptying after hemigastrectomy with Billroth II reconstruction. / Tyndall, Steven H.; Memon, Muhammed Ashraf; Lund, Richard J.; Beck, David; Fessenden, John; Stegman, Mary Ruth; Fitzgibbons, Robert Joseph.

In: European Journal of Gastroenterology and Hepatology, Vol. 11, No. 12, 1999, p. 1359-1364.

Research output: Contribution to journalArticle

Tyndall, Steven H. ; Memon, Muhammed Ashraf ; Lund, Richard J. ; Beck, David ; Fessenden, John ; Stegman, Mary Ruth ; Fitzgibbons, Robert Joseph. / The effect of the anastomotic size on gastric emptying after hemigastrectomy with Billroth II reconstruction. In: European Journal of Gastroenterology and Hepatology. 1999 ; Vol. 11, No. 12. pp. 1359-1364.
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abstract = "Objective. To determine if the size of the gastrojejunal anastomosis after Billroth II reconstruction was the rate-limiting factor in gastric emptying in the postoperative period. Methods. Twelve mongrel dogs were randomized to have either 1.5 cm or 5 cm gastrojejunal anastomoses prior to Billroth II hemigastrectomy. Each dog had three solid and three liquid radiolabelled emptying studies pre- and postoperatively. Data were collected using a gamma camera. For liquid studies, images were obtained at 0 min, 2 min, 4 min, 6 min, 8 min, 10 min, 20 min, 30 min, 40 min, 50 min and 60 min. For solid studies, images were obtained at 0 min, 5 min, 10 min, 20 min, 30 min, 40 min, 50 min, 60 min, 70 min, 80 min, 90 min, 100 min, 110 min and 120 min. Means were compared by analysis of variance using the repeated measures option. Results. Postoperative liquid emptying was significantly faster in the first 10 min with both 1.5 cm and 5 cm anastomoses compared with preoperative scans in the same animals (45{\%} versus 20{\%} and 48{\%} versus 29{\%}, respectively). On the other hand, solid gastric emptying was much slower postoperatively with the 1.5 cm anastomosis compared with preoperative scans (29{\%} versus 65{\%}) as well as compared with postoperative 5 cm anastomosis (29{\%} versus 62{\%}) at the end of 120 min. Conclusions. Our model suggests that the gastric emptying of solids is affected by the size of the gastrojejunal anastomosis and not by the diameter of the efferent limb of the small intestine following Billroth II reconstruction.",
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