STUDY FOR THE CAUSE OF DELAYED GASTRIC EMPTYING AFTER PYLORUS-PRESERVING PANCREATODUODENECTOMY

为了解释保留幽门的胰管切除术（PPPD）后胃排空延迟的原因，我们在杂种狗中进行了下述实验。将应变计力传感器（SGT）连接到三组动物的胃体、胃窦和抬起的空肠上：对照组、PPPD急性组和PPD慢性组，观察肠道运动。对照组在消化间期胃体部和胃窦部有规律地出现间歇性移行复合波（IMC），平均持续时间为15分42秒，平均周期为108分钟。在PPPD急性犬中，排空延迟，胃内容物滞留和幽门环开放得到证实。在PPPD慢性犬中，在POD 14，在体部和胃窦中出现类似IMC的强收缩组，B ...更多信息 但周期和持续时间均不规则。将该收缩组与IMC组比较，收缩组在术后14天的起始周期和持续时间明显短于IMC组，术后28天的持续时间明显短于IMC组，但起始周期无差异。但IMD并不发生在胃体或胃窦中，而且短时间的强收缩组不规则地发生，这似乎是胃内容物滞留的原因。慢性期胃排空恢复，出现类似IMC的强收缩群。然而，当这个强收缩组出现时，血胃动素浓度低于对照组中IMC发生时，并且与十二指肠切除相关的胃动素产生的减少似乎也是导致PPPD后胃内容物滞留的原因之一。少

We performed the experiments described below in mongrel dogs in order to explain the cause of delayd gastric emptying after pylorus-preserving pancreatoduodenectomy (PPPD). Strain gauge force transducers (SGT) were attached to the body of the stomach, the antrum, and the lifted jejunum, in three groups of animals : a control group, a PPPD-acute group, and a PPD-chronic group, and intestinal motility was observed. Gastric emptying was simultaneously monitored by blood acetaminophen aconcentrations, and blood motilin concentrations were also determined.In the control group, intermittent migrating complexes (IMC) having a mean duration of 15 min 42 sec occurred regularly with a mean cycle of 108 min in the interdigestive state in the body and antrum. In the PPPD-acute dogs, emptying was delayd, and retention of gastric contents and the patency of the pyloric ring were confirmed. In the PPPD chronic dogs, a strong contraction group resembling IMC emerged on POD 14 in the body and antrum, b … More ut the cycle and the duration were both irregular. When this contraction group and IMC were compared, the initiation cycle and the duration in the contraction group on POD 14 were significantly shorter compared to the IMC.On POD 28, the duration was significantly shorter, but there was no difference in the initiation cycle.The pyloric ring of the dogs was patent in the early period after PPPD,but the fact that IMD did not occur in the body or the antrum and that a strong contraction group of short duration occurred irregularly appeared to be responsible for the retention of gastric contents. In the chronic period, a strong contraction group resembling IMC was observed, and the gastric emptying recovered. However, the blood motilin concentrations when this strong contraction group emerged were lower than when IMC occurred in the control group, and the decrease in motilin production associated with removal of the duodenum also appeared to be one of the causes that led to the retention of gastric contents after PPPD. Less