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Effect of plasma cholecystokinin on the development of reflux esophagitis after B-1 gastrectomy.

血浆胆囊收缩素对 B-1 胃切除术后反流性食管炎发生的影响。

基本信息

批准号：
15591378
负责人：
MIYAZAKI Shinichi
金额：
$ 1.92万
依托单位：
Chiba University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2003
资助国家：
日本
起止时间：
2003 至 2004
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-15591378/
关键词：
Kholecystokinin B-1 gastrectomy remnant stomach motility reflux esophagitis cholecystokinin

项目摘要

(1)Gastric emptying is a highly regulated process, and plasma CCK plays a major role in its feedback regulation. The gastroduodenal motility and gastric emptying of the two anastomosis-methods after B-I gastrectomy were characterized, while assessing the effect of CCK on the motility of the remnant stomach. Remnant stomachs with side-to-end anastomosis showed superior motility as compared to those with end-to-end anastomosis. Plasma CCK was higher in the end-to-end group, and might explain the difference in motility index between the two groups. (2)B-I gastrectomy causes accelerated gastric emptying. Upon duodenal distention, motility of gastric remnant was significantly inhibited, however, no reduction in duodenal MI was observed. The response was maintained for as long as duodenal distension continued. After evacuation of the balloon, MI returned to pre-distension levels. Increased plasma levels of CCK were observed upon distention of the duodenal balloon. Increased levels of plasma … More CCK during distention might play a role in this feedback mechanism. (3)We compared the clinical outcome after mechanical stapling with that after hand suturing in patients who underwent B-I gastrectomy. A prospective randomized trial showed that the stapling anastomosis method was quicker than the hand-suturing method. Anastomotic complications were similar for the two methods. (4)Endoscopic evaluation of the post operative status was done in the patients reconstructed by the jejunal interposition after total gastrectomy, while comparing those results with the patients reconstructed by the Roux-en-Y technique. Stenosis of anastomosis or reflux esophagitis were found in IP group.Mechanosensory stimulation of the digestive tract influences postprandial release of CCK. Transient lower esophageal sphincter relaxations(TLESRs), which have been shown to be the main mechanism of gastro-esophageal reflux disease, are significantly increased by gastric distention in dogs and humans. Gastric distention is a potent trigger for TLESRs probably causes activation of mechanoreceptors in the subcardiac region of the stomach even after B-I gastrectomy and the release of CCK, which might partly play a role of the reflux esophagitis after B-1 gastrectomy. Less

（1）胃排空是一个高度调节的过程，血浆CCK在其反馈调节中起主要作用。观察两种吻合方法对胃十二指肠运动和胃排空的影响，并观察CCK对残胃运动的影响。与端端吻合相比，侧端吻合的残胃显示出上级运动性。血浆CCK在端对端组中较高，这可能解释了两组之间运动指数的差异。（2）B-I胃切除术后胃排空加快。十二指肠扩张后，残胃运动明显受到抑制，但十二指肠MI并未减少。只要十二指肠扩张持续，反应就会维持。球囊排空后，MI恢复至扩张前水平。十二指肠球囊扩张后，观察到血浆CCK水平升高。血浆水平升高 ...更多信息扩张时的CCK可能在这种反馈机制中发挥作用。(3)We比较了接受B-I胃切除术的患者机械吻合后与手工缝合后的临床结局。一项前瞻性随机试验表明，吻合器吻合方法比手动吻合方法更快。两种方法的吻合口并发症相似。（4）对全胃切除术后空肠间置代胃术的患者进行内镜下评估，并与Roux-en-Y代胃术的患者进行比较。IP组出现吻合口狭窄或反流性食管炎，消化道机械感觉刺激影响餐后CCK释放。短暂性下食管括约肌松弛（TLESR），这已被证明是胃食管反流病的主要机制，显着增加胃扩张犬和人。胃扩张是TLESRs的一个强有力的触发因素，可能导致即使在B-I胃切除术后胃心下区的机械感受器激活和CCK的释放，这可能在B-1胃切除术后反流性食管炎中起部分作用。少

项目成果

期刊论文数量（31）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

平山信男, 軍司祥雄 et al.: "胃全摘術における有茎空腸間置再建とRoux-Y再建の比較"日本消化器外科学会誌. 36. 872-872 (2003)

Nobuo Hirayama、Yoshio Gunji 等：“全胃切除术中带蒂空肠介入重建和 Roux-Y 重建的比较”日本胃肠外科杂志 36. 872-872 (2003)。

DOI：
发表时间：
期刊：
影响因子：
0
作者：
通讯作者：

Inhibitory remnant stomach motility by duodenal distention after B-1 gastrectomy.

B-1 胃切除术后十二指肠扩张抑制残余胃运动。

DOI：
发表时间：
2005
期刊：
Hepato-Gastorenterology 52
影响因子：
0
作者：
Hirayama;N.;Gunji;Y.;Miyazaki;S.;Kaiho;T.;Shimada;H.;Matsubara;H.;Nabeya;Y.;Aoki;T.;Kobayashi;S.;Ochiai;T.
通讯作者：
T.

Evaluation of reconstruction method with interposition after total gastrectomy.

全胃切除术后介入重建方法的评价。