Abstracts 1997 Digestive Disease Week
Gastrointestinal motility following pylorus-preserving
duodenectomy in the dog.
D DeHaan, J Spitz, V Ayasononda, H Richter. Departments of Surgery, Cook
County Hospital and Rush University, Chicago, IL.
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The location and function of the duodenum endow this intestinal segment with
special importance. Our aims were to establish a canine model resembling human
anatomy following pylorus-preserving pancreaticoduodenectomy, and to determine
the gastrointestinal motor patterns of this model. Materials and Methods Adult
beagles underwent resection of duodenum from 1 cm distal to the pylorus. The
distal common bile duct was resected, while the pancreatic duct orifice was
preserved attached to a button of duodenal wall. The transected jejunum was
joined to gallbladder, the pancreatic duct re-implanted into the jejunum 10 cm
distally, and the duodenal cuff anastomosed to jejunum another 20 cm aborally.
Side-hole manometric catheters were implanted in the gastric fundus, antrum 3
and 6 cm proximal to pylorus, and jejunum 10 cm proximal and 10 and 20 cm distal
to the duodenal anastomosis. Control dogs underwent analogous placement of
catheters only. Following recovery, dogs underwent at least 3 fasting and 3 fed
studies of GI motor activity using a low-compliance pneumohydraulically perfused
manometric system linked to pressure transducers and a chart recorder.
Recordings were analyzed visually for presence of cyclic and migrating fasting
motor patterns, interruption of same by a meal, and occurrence of a "fed"
gastric motor pattern. Results Duodenectomy caused weight loss, but dogs
otherwise remained well. All 4 controls exhibited classic gastric cyclic
activity tightly phase-linked to small bowel MMC's, and all converted to a
typical fed pattern. After duodenectomy, all 5 dogs displayed fasting cyclic
migrating small bowel activity fronts resembling the control MMC pattern, and
all had fasting gastric contractions; in 2 of 5, this was clearly cyclic and
phase-linked to small bowel cycles, whereas in 3, no such organization was
apparent. After a meal, the small bowel and gastric (when present) fasting
cyclic pattern was replaced by a fed-type pattern, including 5/min antral
peristalsis. Conclusion Pylorus-Preserving Duodenectomy maintains small bowel
MMC-like motility and gastrointestinal fed pattern, but interferes with fasting
gastric cyclic activity and gastric-enteric coordination.
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