Dual-radionuclide simultaneous gastric emptying and bile transit study after gastric surgery with double-tract reconstruction
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The physiology of gastrointestinal transfer function after proximal gastrectomy with bypass-tract reconstruction is not well understood. We applied a simultaneous dual-radionuclide method with a hepatobiliary imaging and gastric emptying study to evaluate physiologic alterations occurring after surgery.
Nineteen patients with early gastric cancer, including 9 pre-operative control patients and 10 who had proximal gastrectomy and double-tract reconstruction surgery were examined by dual-radionuclide hepatobiliary and gastric emptying studies (99mTc PMT and111In DTPA). Retention fraction in the stomach at 3 minutes (R3) and 60 minutes (R60) and gastric emptying half-time (GET) were calculated. Bile reflux and mixture of bile and food were also evaluated.
The retention fractions of R3 and R60 were significantly lower in the double-tract reconstruction group than those in the preoperative group. GET differed significantly between the double-tract and preoperative groups (20.7 min ±7.1 min and 36.2 min ± 11.0 min, p = 0.0018). The mixture of bile and food was not good in the double-tract reconstruction group (p = 0.014 vs. preoperative). Patients with a large residual stomach showed slower initial emptying (p = 0.0068) and a better mixture of bile and food (p = 0.058) compared to those with a small residual stomach. The bile reflux was not significantly increased after surgery.
The dual-radionuclide gastrointestinal and hepatobiliary imaging was feasible and could demonstrate characteristic transit patterns of the foods and bile in the double-tract reconstruction procedure. A larger residual stomach, if possible, is desirable to provide better transfer and mixing of bile and foods.
Key wordsgastric emptying study gastric cancer postoperative study hepatobiliary imaging dual-radionuclide acquisition
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- 17.Miwa K, Kinami S, Nakagawara K, Bando E, Taniguchi K, Fushida S, et al. The strategy of the surgical treatment towards gastric cancer located in the upper third of the stomach.Gekachiryo (Surgical Therapy) 2000; 83:59–66.[in Japanese]Google Scholar