Abstract
The gastric emptying of 10, 20, or 40 ml/kg body mass milk meals was measured before and after Heineke-Mikulicz pyloroplasty of 3, 5, or 7 cm (6 dogs) or truncal vagotomy (3 dogs). The pyloroplasty group then underwent vagotomy, following which the tests were repeated. Initial gastric emptying (in the first 10 min) was increased after 5-and 7-cm pyloroplasties (P<0.01) and particularly after vagotomy with all sizes of pyloroplasty (P=0.001). Regardless of the volume of meal used, after vagotomy and pyloroplasty there was a 51–63% decrease in intragastric volume within the first 10 min. Increased duodenogastric reflux occurred in those dogs who showed rapid initial gastric emptying. After the first 10 min all groups were shown to have virtually normal gastric emptying, except the truncal vagotomy group in which gastric emptying was delayed (P<0.05). It is the combination of pyloroplasty with vagotomy which is required to produce the very rapid initial gastric emptying of a liquid meal following vagotomy with pyloroplasty. It is concluded that two mechanisms control the gastric emptying of a milk meal. The first acts quickly, is dependent on an intact pylorus, and is influenced by the intragastric volume; the second is a more slowly acting mechanism, requiring up to 10 min to have its effect, and is not dependent on an intact pylorus or the intragastric volume. After vagotomy and pyloroplasty, the speed of gastric emptying in the first 10 min is proportional to the original meal volume, and therefore the therapy of postvagotomy diarrhea and dumping with small frequent meals seems rational.
Similar content being viewed by others
References
Aylett P, Wastell C, Wise L: Gastric secretion and emptying before and after vagotomy and pyloroplasty, with and without continuous infusion of peptavlon pentagastrin. Am J Dig Dis 14:245–252, 1969
McKelvey STD: Gastric incontinence and post vagotomy diarrhoea. Br J Surg 57:741–747, 1970
Cobb JS, Bank S, Marks IN, Louw JH: Gastric emptying after vagotomy and pyloroplasty. Am J Dig Dis 16:207–215, 1971
Buckler KG: Effect of gastric surgery upon gastric emptying in cases of peptic ulceration. Gut 8:137–147, 1967
Alexander Williams J, Cox A: After Vagotomy, 1st ed. London, Butterworths, 1969
Heading RC, Tothill P, McLoughlin GP, Shearman DJC: Effect of gastric surgery on differential emptying of solid and liquid components of the gastric contents. Br J Surg 62:659, 1975
Gunn IF, Harding KD, Brown A, Williams JA: An assessment of clinical tests of gastric emptying, before and after operation. Br J Surg 60:307, 1973
Haynes S, Thompson JPS, Brown N, Keeling DH: A study of the relationship between the rate of gastric emptying and the dumping syndrome after vagotomy and drainage. Br J Surg 60:307–308, 1973
Colmer MR, Owen GH, Shields R: Pattern of gastric emptying after vagotomy and pyloroplasty. Br Med J 2:448–450, 1973
Clarke RJ, Alexander Williams J: The effect of preserving antral innervation and of a pyloroplasty, on gastric emptying after vagotomy in man. Gut 14:300–307, 1973
Clarke RJ, McFarland JB, Alexander Williams J: Gastric stasis and gastric ulcer after selective vagotomy, without a drainage procedure. Br Med J 1:538–539, 1972
Dragstedt LR, Harper PV, Tovee EB, Woodward ER: Section of the vagus nerves to the stomach in the treatment of peptic ulcer. Ann Surg 126:687–708, 1947
Wilbur BC, Kelly KA: Effect of proximal gastric, complete gastric and truncal vagotomy on canine gastric electrical activity, motility and emptying. Ann Surg 178:295–303, 1973
Springfield AC, Weddle CO, Ormsbee HS III: Influence of truncal vagotomy on canine gastric emptying of liquids. Am J Surg 128(5):678–682, 1974
Hall WH, Read RC: Effect of vagotomy on gastric emptying. Am J Dig Dis 15:1047–1053, 1970
Ludwick JR, Wiley JN, Bass P: Gastric emptying following Finney pyloroplasty and vagotomy. Am J Dig Dis 15:347–352, 1970
Hinder RA, Bremner CG: A radioisotope method of measuring intragastric volumes using the Volémetron. Gut 14:113–115, 1973
Hinder RA, Bremner CG, Horn BKP: A radioisotope method of measuring gastric emptying reflux and secretion. Br J Surg 59:903, 1972
Hinder RA, Horn BKP, Bremner CG: The volumetric measurement of gastric emptying and gastric secretion by a radioisotope method. Am J Dig Dis 21:940–945, 1976
Wastell C: Chronic Duodenal Ulcer, 1st ed. London, Butterworths, 1972
Armitage P: Statistical Methods in Medical Research, 1st ed. Oxford; Blackwell Scientific Publications, 1971, pp 279–284
Jahnberg T, Martinson J, Hulten L, Fasth S: Dynamic gastric response to expansion before and after vagotomy. Scand J Gastroenterol 10:593–598, 1975
Stadaas JO: Intragastric pressure/volume relationship before and after proximal gastric vagotomy. Scand J Gastroenterol 10:129–134, 1975
Muren A: Gastric motility after vagotomy in dogs. Acta Chir Scand 112:98–106, 1957
Donovan IA, Keighley MRB, Griffin DW, Harding LK, Alexander Williams J: The association of duodenogastric reflux with dumping and gastric retention. Br J Surg 63:349–351, 1976
Hunt JN, MacDonald I: The influence of volume on gastric emptying. J Physiol 126:459–474, 1954
Author information
Authors and Affiliations
Additional information
This report is based on a PhD (Med) thesis presented to the University of the Witwatersrand, Johannesburg.
This work was funded by the University of the Witwatersrand, Miller Foundation and Medical Research Council of South Africa.
Rights and permissions
About this article
Cite this article
Hinder, R.A., Bremner, C.G. Relative role of pyloroplasty size, truncal vagotomy, and milk meal volume in canine gastric emptying. Digest Dis Sci 23, 210–216 (1978). https://doi.org/10.1007/BF01072319
Issue Date:
DOI: https://doi.org/10.1007/BF01072319