This study compares antegrade gastric and Roux-limb electrical pacing in the evaluation and treatment of delayed gastric emptying following vagotomy, antrectomy and Roux-Y enterostomy. Twenty-four male Sprague-Dawley rats (250 g) underwent midline laparotomy, truncal vagotomy, antrectomy, and Roux-Y jejunostomy. Pacemaker leads were implanted 1 cm apart in both the gastric fundus and proximal Roux limb. Pacing was accomplished using a 0.5 mA, 50 msec, 0.33 Hz signal and monitored by an oscilloscope. Animals were fasted for 2 hr and then gavaged with 1.0 cc of 99mTc-labeled egg white. At 1 hr rats were anesthetized. The stomach, Roux limb, small intestine, and colon were doubly ligated and excised without disturbing their contents. The total number of counts per minute per rat was determined in a gamma radiation counter, and percentage gastric emptying (GE) was evaluated. Group I controls (n = 8) retained 76 ± 15.8% for a GE of 24%. Group II gastric paced rats (n = 8) retained 64.5 ± 19.2% (GE 35.5%) and Group III Roux-limb paced rats (n = 8) retained 46.8% ± 13.2 (GE 53.2%) (P < 0.005 III vs I, P < 0.05 III vs II). The amount of radioactive meal distal to the Roux limb was also evaluated. Group I had 15.7 ± 16.1%, Group II (gastric paced) 20.5 ± 19.0%, and Group III (Roux-limb paced) 37.2 ± 11.9% (P < 0.005 III vs I, P < 0.05 III vs II). These data imply that Roux-en-Y limb dysmotility may contribute to delayed gastric emptying following vagotomy, antrectomy, and Roux-Y enterostomy. These observations also suggest that antegrade electrical pacing may be useful clinical adjunct in resolving this problem.
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