Gastric Phase 3 Motility After Pylorus-preserving Pancreatoduodenectomy

Overview

Journal Ann Surg

Specialty General Surgery

Date 2002 Mar 8

PMID 11882764

Citations 7

Authors

Takao Ohtsuka

Shunichi Takahata

Jiro Ohuchida

Torahiko Takeda

Hiroaki Matsunaga

Kazunori Yokohata

Koji Yamaguchi

Kazuo Chijiiwa

Masao Tanaka

Affiliations

Soon will be listed here.

Abstract

Objective: To analyze factors affecting the recovery course of phase 3 activity of the gastric migrating motor complex after pylorus-preserving pancreatoduodenectomy (PPPD) and investigate effects of the recovery of gastric phase 3 on gastric emptying after feeding.

Summary Background Data: Whether early recovery of gastric phase 3 during fasting would predict early recovery of the fed-state gastric emptying function after PPPD has not been well documented.

Methods: Manometric recording from the gastric antrum was repeated at a weekly interval until the first appearance of gastric phase 3 in 57 patients after PPPD. Twenty-three clinical parameters were assessed as possible factors affecting the recovery course of gastric phase 3 by simple and multiple regression analyses. A gastric emptying study after feeding of a test meal was performed by the acetaminophen method and the values were compared between patients with and without gastric phase 3 after PPPD.

Results: The mean period before the first appearance of gastric phase 3 was 38 days. Among 23 parameters, only lymph node dissection along the hepatoduodenal ligament significantly delayed recovery of gastric phase 3 after PPPD by univariate and multivariate analyses. The presence or absence of gastric phase 3 in the early postoperative period did not influence gastric emptying after feeding in the intermediate period after PPPD.

Conclusions: Avoiding lymph node dissection along the hepatoduodenal ligament, if applicable, may contribute to early recovery of gastric phase 3 after PPPD. The recovery state of gastric phase 3 during fasting, however, is not necessarily consistent with the degree of improvement of gastric emptying after feeding.

Citing Articles

Intraoperative Endoluminal Pyloromyotomy Versus Stretching of the Pylorus for the Reduction of Delayed Gastric Emptying After Pylorus-Preserving Partial Pancreatoduodenectomy: A Blinded Randomized Controlled Trial (PORRIDGE Study; DRKS00013503).

Schrempf M, Anthuber M, Spatz J, Sommer F, Vlasenko D, Geissler B Ann Surg Oncol. 2025; .

PMID: 39904851 DOI: 10.1245/s10434-025-16950-5.

Body surface gastric mapping to determine gastric motility patterns associated with delayed gastric emptying after pancreaticoduodenectomy. Gastric Electric Mapping after Pancreatoduodenectomy study protocol.

Mentor K, Lembo J, Carswell S, Jones M, Pandanaboyana S BMJ Open. 2022; 12(12):e066864.

PMID: 36456028 PMC: 9716948. DOI: 10.1136/bmjopen-2022-066864.

Delayed Gastric Emptying and Gastric Remnant Function After Pancreaticoduodenectomy: A Systematic Review of Objective Assessment Modalities.

Wang T, Lin A, Mentor K, OGrady G, Pandanaboyana S World J Surg. 2022; 47(1):236-259.

PMID: 36274094 PMC: 9726783. DOI: 10.1007/s00268-022-06784-7.

Intraoperative endoluminal pyloromyotomy for reduction of delayed gastric emptying after pylorus preserving partial pancreaticoduodenectomy (PORRIDGE trial): study protocol for a randomised controlled trial.

Schrempf M, Pinto D, Wolf S, Geissler B, Sommer F, Hoffmann M Trials. 2022; 23(1):74.

PMID: 35078510 PMC: 8787914. DOI: 10.1186/s13063-022-06032-2.

Does the Ileal Brake Contribute to Delayed Gastric Emptying After Pancreatoduodenectomy?.

Barreto S, Windsor J Dig Dis Sci. 2016; 62(2):319-335.

PMID: 27995402 DOI: 10.1007/s10620-016-4402-0.

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