Gastric emptying after partial gastrectomy without vagotomy with primary Roux-en-Y or Billroth II anastomosis

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Abstract
Several clinical studies have indicated that gastric emptying is delayed in patients with Roux-en-Y biliary diversion with vagotomy. In order to determine whether Roux-en-Y diversion without vagotomy also induces delayed gastric emptying, we have compared the effect of gastrectomy without vagotomy with either Billroth II or Roux-en-Y anastomosis on gastric emptying of a liquid and solid meal in 22 peptic ulcer patients. The emptying half-times (t1/2) for solid food were not significantly different, 54; 24-122 min (median and range) in the 11 patients with Billroth II gastrectomy, 68; 44-189 min in the 11 patients with Roux-en-Y gastrectomy, and 83; 27-114 min in 11 normal control subjects. However, the lag phase was significantly (p less than 0.01) shorter in the patients with Billroth II gastrectomy (5; 0-43 min) and Roux-en-Y gastrectomy (4; 2-12 min) than in the control subjects (10; 4-22 min). The t1/2's for the fluid meal were similar, 7; 4-49 min after Billroth II gastrectomy, 8; 4-32 min after Roux-en-Y gastrectomy, and 9; 3-20 min in the control subjects. In all subjects the lag phase for the fluid meal was very short, ranging from 0 to 3 min. It is concluded that Roux-en-Y diversion per se does not delay gastric emptying in man.

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