FUNCTIONAL STATE OF THE STOMACH AND SMALL BOWEL AFTER SURGERY FOR PANCREATIC DUCTAL ADENOCARCINOMA
https://doi.org/10.16931/1995-5464.2016262-67
Abstract
Aim. To identify the most physiological type of anastomosis in palliative and radical surgery in patients with pancreaic head cancer using assessment of functional state of the stomach and small bowel.
Materials and Methods. It was performed prospective research of functional state of the stomach and small bowel in patients with pancreatic head cancer who underwent palliative and radical surgery. There were 37 patients after radical surgery and 111 examinations. All of them had ductal adenocarcinoma of the pancreatic head. In the first sub-group 19 patients underwent Whipple procedure and in the second sub-group 18 patients had pylorus preserving pancreatic resection (PPPD). Palliative interventions were made in 23 cases. 11 patients (sub-group 1) underwent Wolfler procedure and 12 patients (sub-group 2) — Gakker procedure.
Results. The most positive dynamics was registered in the PPPD group (half-life period of delayed gastric emptying reduced from 118.8 min to 46.2 min in 15 days after surgery). Also good dynamics was registered in the Gakker group (half-life period of delayed gastric emptying reduced from 102.5 minutes in 7 days after surgery to 51.7 minutes in one month after surgery). In patients after Wolfler procedure this parameter reduced from 114.2 min to 64.8 min in 15 days after surgery.
Conclusion. Radionuclide diagnostic method makes possible not only to examine state of the stomach,About the Authors
A. V. Shabunin
Botkin Municipal Hospital;
Russian Medical Academy of Postgraduate Education, Ministry of Health of the Russian Federation
Russian Federation
Shabunin Alexey Vasilievich — Doct. of Med. Sci., Professor, Head of the Chair of Surgery, Russian Medical Academy of Postgraduate Education, Head Physician of Botkin Municipal Hospital
Russian Federation
Shabunin Alexey Vasilievich — Doct. of Med. Sci., Professor, Head of the Chair of Surgery, Russian Medical Academy of Postgraduate Education, Head Physician of Botkin Municipal Hospital
M. M. Tavobilov
Botkin Municipal Hospital;
Russian Medical Academy of Postgraduate Education, Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Tavobilov Mikhail Mikhailovich - Cand. of Med. Sci., Associate Professor of the Chair of Surgery, Russian Medical Academy of Postgraduate Education, Head of the Department of Liver and Pancreatic Surgery, Botkin Municipal Hospital
For correspondence: Tavobilov Mikhail Mikhailovich — 2nd Botkinsky pr., Moscow, 125284, Russian Federation
A. A. Karpov
Botkin Municipal Hospital
Russian Federation
Karpov Alexey Andreevich — Surgeon at the Department of Liver and Pancreatic Surgery
Russian Federation
Karpov Alexey Andreevich — Surgeon at the Department of Liver and Pancreatic Surgery
References
1. Kotoura Y., Takahashi T., Ishikawa Y., Ashida H., Hashimoto N., Nishioka A., Fukuda M. Hepatobiliary and gastrointestinal imaging after pancreaticoduodenectomy — a comparative study on Billroth I and Billroth II reconstructions. Jpn. J. Surg. 1990; 20 (3): 294—299. PMID: 2359205.
2. Donohoe K.J., Maurer A.H., Ziessman H.A., Urbain J.L., Royal H.D., Martin-Comin J. Procedure guideline for adult solid-meal gastric-emptying study 3.0. J. Nucl. Med. Technol. 2009; 37 (3): 196—200. doi: 10.2967/jnmt. 109.067843.
3. Abell T.L., Camilleri M., Donohoe K., Hasler W.L., Lin H.C., Maurer A.H., McCallum R.W., Nowak T, Nusynowitz M.L., Parkman H.P, Shreve P., Szarka L.A., Snape WJ. Jr., Ziess- man H.A. Consensus recommendations for gastric emptying scintigraphy: ajoint report ofthe American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. Am. J. Gastroenterol. 2008; 103 (3): 753—763. PMID: 18287197.
4. Chan D.C., Fan Y.M., Lin C.K., Chen C.J., Chen C.Y., Chao Y.C. Roux-en-Y reconstruction after distal gastrectomy to reduce enterogastric reflux and Helicobacter pylori infection. J. Gastrointest. Surg. 2007; 11 (12): 1732—1740. PMID: 17876675.
5. Mariani G., Boni G., Barreca M., Bellini M., Fattori B., AlSharif A., Grosso M., Stasi C., Costa F., Anselmino M., Marchi S., Rubello D., Strauss H.W. Radionuclide gastroesophageal motor studies. J. Nucl. Med. 2004; 45 (6): 1004—1028. PMID: 15181137.
6. Guo J.P, Maurer A.H., Fisher R.S., Parkman H.P. Extending gastric emptying scintigraphy from two to four hours detects more patients with gastroparesis. Dig. Dis. Sci. 2001; 46 (1): 24—29. PMID: 11270790.
7. Houghton L.A., Reed N.W., Heddle R., Horowitz M., Collins P.J., Chatterton B., Dent J. Relationship of themotor activity of the antrum, pylorus and duodenum to gastric emptying of a solid-liquid mixed. Gastroenterology. 1988; 94 (6): 1285—1291. PMID: 3360256.
8. Noh S.M. Improvement of the Roux limb function using a new type of “uncut Roux” limb. Am. J. Surg. 2000; 180 (1): 37—40. PMID: 11036137.
9. Le Blanc-Louvry I., Ducrotte P., Peillon C., Testart J., Denis P., Michot F., Teniere P. Upper jejunal motility after pancreatoduodenectomy according to the type of anastomosis, pancreatico- jejunal or pancreaticogastric. J. Am. Coll. Surg. 1999; 188 (3): 261—270. PMID: 10065815.
10. Nakajima K., Kawano M., Kinami S., Fujimura T., Miwa K., Tonami N. Dual-radionuclide simultaneous gastric emptying and bile transit study after gastric surgery with double-tract reconstruction. Ann. Nucl. Med. 2005; 19 (3): 185—191. PMID: 15981670.
Review
For citations:
Shabunin A.V., Tavobilov M.M., Karpov A.A. FUNCTIONAL STATE OF THE STOMACH AND SMALL BOWEL AFTER SURGERY FOR PANCREATIC DUCTAL ADENOCARCINOMA. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2016;21(2):62-67. (In Russ.) https://doi.org/10.16931/1995-5464.2016262-67
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