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Comparison of the Differences of Gastric Emptying Time after Upper Gastrointestinal Surgeries Using the Acetaminophen Method

Other Title
Acetaminophen을 이용한 상부위장관수술후 위배출기능의 차이의 비교
Authors
한, 상욱; 김, 욱환; 조, 용관; 김, 명욱
Citation
Taehan Oekwa Hakhoe, 54(4):501-507, 1998
Journal Title
Taehan Oekwa Hakhoe; 대한외과학회지
ISSN
1226-0053
Abstract
Gastric emptying in patients after several upper gastrointestinal surgeries was studied using

the acetaminophen method. The subjects consisted of 23 gastric cancer patients, 2 duodenal

ulcer patients, 5 periampullary cancer patients and 4 normal subjects. As an indicator of the

gastric emptying rate, the serum acetaminophen concentration was measured by fluorescence

polarization immunoassay, in units of ㎍/ml, at 0, 30, 60, 120, and 180 minutes after ingestion

of a liquid meal with 1.5g of acetaminophen. In the normal subjects, the acetaminophen

concentrations were 0, 16.35±5.06, 18.71±5.58, 16.38±4.82, and 11.09±3.62 ㎍/ml at time 0, 30,

60, 120, and 180 min, respectively. The concentration peaked at 60 min after ingestion of the

test meal in the normal subjects. We observed significant delayed gastric emptying after

pancreas preserving pancreaticoduodenectomy (PPPD) and a standard Whipple's operation in

the early postoperative period. In all patients with a subtotal gastrectomy, a truncal

vagotomy was done. However, in patients with a pancreaticoduodenectomy, the vagus nerves

were preserved. The gastric emptying pattern was different between the patients with a

subtotal gastrectomy and the patients with a pancreaticoduodenectomy, despite similar

reconstructions of the gastroenterostomy (Billroth Ⅰ or Billroth Ⅱ type reconstruction). There

was more rapid gastric emptying in patients with a truncal vagotomy and pyloroplasty than

in the normal subjects. Hence, we speculate that the truncal vagotomy was the main cause

of the different gastric emptying etween the atients with a pancreaticoduodenectomy and the

patients with a subtotal gastrectomy.
Keywords
AcetaminophenGastric emptying time
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Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
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