Abstracts
2000 Digestive Disease Week

# 2329 KW5139 (Synthesized 13-Leu-Motilin) Ameliorate Postoperative Gastric Stasis Caused by Hypogastroduodenal and Hyperpyloric Motility at Early After Abdominal Surgery.
Koji Nakada, Nobuyoshi Hanyu, Teruaki Aoki, Tokyo, Japan

Impaired gastroduodenal motility is common after abdominal surgery. This may be a cause of postoperative gastric stasis, therefore, the insertion of naso-gastric tube is often required to decompress the stomach. Aims. To study motility of upper gasrtointestine at early after abdominal surgery and to study the effect of KW5139 (synthesized 13-leu-motilin, Kyowa Hakko; KW) on postoperative gastric stasis. Methods: Motility was recorded in control (n=6) and in small bowel auto transplanted (AT) dogs (n=6) by multiple implanted strain gauge force transducers. Fasted recordings was made on postoperative day (POD) 1, 3, 7 and 14 for at least 6 hours. In AT dogs, KW (0.1 mg/kg) was given intravenously after baseline recordings. Strong, repetitive, phasic contractions lasting more than 4 minutes, which simultaneously occurred in the stomach and in the duodenum was defined as phase 3. Motor pattern, the incidence of phase 3 and motor effect of KW was compared. Barium meal study was also performed in AT dogs under fluoroscopy on POD 3, and the effect of KW on gastric emptying was examined. Results: Mean operation time was 1.3 hrs vs 5.4 hrs, in control and in AT dogs, respectively. Surgical procedures added to the gastroduodenum was mere suturing of sensors both in control and AT dogs. The occurrence of motor events in the stomach and duodenum was rare within 3 days after operation, while the occurrence of contractions of high amplitude were frequently seen in the pylorus at this early time period both in control and in AT dogs. The incidence of phase 3 (N/hr) was, 0±0 vs 0.27±0.1 vs 0.43±0.03 vs 0.46±0.03, in control dogs on POD 1, 3, 7, 14, and 0±0 vs 0.02±0.02 vs 0.07±0.03 vs 0.07±0.07, in AT dogs on POD 1, 3, 7, 14, respectively. KW always induced phase 3-like contractions in the gastroduodenum even on POD 1. In the barium meal study, host stomach was rather dilated and of rare motor events. After injection of KW, vigorous peristaltic contractions always occurred in the gastroduodenum and most of stagnated gastric contents was emptied. Conclusions: Increased operation time and surgical stress enhanced gastroduodenal dysmotility at early after abdominal surgery. The pyloric contractions of high amplitude was frequently seen at early after abdominal surgery, could be a cause of postoperative gastric stasis adding to hypogastroduodenal motility. The usage of synthesized motilin seems potent for the treatment of postoperative gastric stasis.