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RISS 인기검색어
- 검색키워드
- 저자 : ( Sanjay Gambhir ) (검색결과 1 건)
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( Biju Pottakkat ),( Deep Parasar ),( Sanjay Gambhir ),( Ashok Kumar ),( Rajan Saxena ),( Vinay Kapoor ) 대한소화기학회 2007 SIDDS Vol.9 No.-
Background/Aims: Early delayed gastric emptying (DGE) is the commonest complication after pylorus preserving pancreato-duodenectomy (PPPD) and an incidence of upto 40% is reported in the literature. Pyloric dysfunction is proposed as the main cause for DGE. This study is aimed to assess the gastric emptying pattern in patients in whom pyloric dilatation was done during PPPD. Methods: All patients who underwent PPPD for periampullary carcinoma between July 2004 and June 2005 were included in this prospective study. Pyloric dilatation was done upto 18 mm with Hegar`s dilators in all patients at operation. Gastric emptying was assessed with nuclear scintigraphy using Tc-99m sulphur colloid labeled semisolid standard meal between post operative day 10 and 14. Time activity curve was plotted for 1 hour and further curve is extrapolated. The clearance half time (T1/2) of gastric emptying was calculated. T1/2 upto 110 minutes is considered as normal. Results: Out of 20 patients who underwent PPPD, study could not be performed in 7 patients because of post operative complications. Gastric emptying was assessed in 13 patients. There were 8 males and 5 females in the age group of 31-57 (mean 48) years. 5/13 (38%) patients had DGE on nuclear scintigraphy inspite of pyloric dilatation. In 4/5 (80%) patients with DGE, time activity curve was flat at 1 hour (Tl/2 indefinite) and in the other patient T1/2 was 290 minutes, 4/5 (80%) patients with DGE demonstrated much delayed clearance in the proximal stomach although the distal pyloric emptying was normal. The other patient had delayed emptying both in proximal stomach and pylorus. 8/13 (62%) patients had normal gastric emptying and the T1/2 ranged between 28-106 (mean 64) minutes. Conclusions: DGE after PPPD as mainly due to the delayed emptying of proximal stomach rather than pylorus. Treatment strategies directed to the pylorus may not alleviate DGE after PPPD.
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