Ectopic jejunal pacemakers and gastric emptying after Roux gastrectomy: Effect of intestinal pacing

Journal Article · Wed Nov 01 04:00:00 EST 1989 · Surgery; (USA)

OSTI ID:5023574

Karlstrom, L; Kelly, K A ^[1]

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1. Mayo Clinic, Rochester, MN (USA)

The aims of this study were to determine whether ectopic pacemakers are present after meals in the Roux limbs of dogs after vagotomy and Roux gastrectomy, whether these pacemakers slow gastric emptying of liquids or solids, and whether abolishing the pacemakers with electric pacing might speed any slow emptying that occurs. In six dogs that underwent vagotomy and Roux gastrectomy and in four dogs that underwent vagotomy and Billroth gastrectomy (controls), myoelectric activity of the Roux limb or duodenum was measured during gastric emptying of a 500 kcal mixed meal of 99mTc-labeled cooked egg and 111In-labeled milk. Roux dogs were tested with and without pacing of the Roux limb. Roux dogs showed ectopic pacemaker in the Roux limb that drove the pacesetter potentials of the limb in a reverse, or orad, direction during 57% of the postprandial recordings. Billroth dogs had no ectopic pacemakers (p less than 0.05). Liquids emptied more slowly in Roux dogs (half-life (t1/2) = 121 +/- 15 minutes) than in Billroth dogs (t1/2 = 43 +/- 9 minutes; p less than 0.05), but solids emptied similarly in both groups of dogs (t1/2 approximately 8 hours). Pacing the Roux limb abolished the ectopic pacemakers, restored the slow emptying of liquids to the more rapid rate found in the Billroth dogs (t1/2: paced Roux, 72 +/- 15 minutes; Billroth, 43 +/- 9 minutes; p greater than 0.05) and did not change emptying of solids. The conclusion was that ectopic pacemakers present in the Roux limb after vagotomy and Roux gastrectomy drove the limb in a reverse direction and slowed emptying of liquids after the operation. The defect was corrected by pacing the Roux limb in a forward direction.

• OSTI ID: 5023574
• Journal Information: Surgery; (USA), Journal Name: Surgery; (USA) Vol. 106:5; ISSN 0039-6060; ISSN SURGA
• Country of Publication: United States
• Language: English

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59 BASIC BIOLOGICAL SCIENCES
ANIMALS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
DAYS LIVING RADIOISOTOPES
DIGESTIVE SYSTEM
DIGESTIVE SYSTEM DISEASES
DISEASES
DOGS
DYNAMIC FUNCTION STUDIES
ELECTRON CAPTURE RADIOISOTOPES
GASTROINTESTINAL TRACT
HOURS LIVING RADIOISOTOPES
INDIUM 111
INDIUM ISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPES
MAMMALS
MEDICINE
MINUTES LIVING RADIOISOTOPES
NUCLEI
ODD-EVEN NUCLEI
PATHOGENESIS
RADIOISOTOPES
SURGERY
TECHNETIUM 99
TECHNETIUM ISOTOPES
TRACER TECHNIQUES
VERTEBRATES
YEARS LIVING RADIOISOTOPES