Effect Of Motilin And Gastrin On Motor Function Of Gastric Remnant After Proximal Subtotal Gastrectomy

Introduction: It is traditional viewpoint that vagus nerve may play an important role in modulating gastrointestinal motion and digestion. Vagotomy perhaps leads to disability of pylorus and delay of gastric emptying. However, most patients without pyloroplasty or drainage didin't occur disability of gastric emptying after proximal subtotal gastrectomy and vagotomy. Gastrointestinal motion is adjusted by both vagus nerve and gastrointestinal hormones. At present, there are much doubt about gastrointestinal hormone adjustment to gastrointestinal motion.Objective: To set up the animal model of proximal subtotal gastrectomy, detect the dynamic changes of motilin and gastrin level in plasm, and investigate the electrophysiology and nuclear gastric emptying of gastric remnant in the condition of proximal subtotal gastrectomy and vagotomy, provide experimental evidence for choosing operative methods and preventing gastric motor dysfunction.Material and Methods: Changes of motilin and gastrin level in plasm were detected in adult hybrid canines before and after the convention, the electrophysiology and nuclear gastric emptying of gastric remnant in the condition of proximal subtotal gastrectomy and vagotomy were investigated simultaneously. 1. Twenty-one hybrid canines were divided into three groups: (1)the control group: Only performing electrode placing operation, (2) the vagotomy group: performing vagotomy plus electrode placing operation, (3)the gastrectomy group: performing proximal subtotal gastrectomy plus electrode placing operation. 2. Postoperative observation: symptoms such as nausea, vomiting and anorexia. 3. Detecting plasm gastrointestinal hormones by radio-immunity. 4. Detecting gastric emptying by nuclear gastric emptying test. 5. Detecting electrogastrogram by BL-410 biological experiment system.Results: 1. Postoperative observation: All canines in the control group had survived 3 months after the operation, None of them had symptoms such as nausea, vomiting and anorexia. Only one canine in the vagotomy group died, another one had mild anorexia symptom in the early stage, others were in good conditions and had survived 3 months. Two dogs in the gastrectomy group died, other two dogs had nausea and emesis symptoms in the early stage, all members in this group displayed various degree of anorexia symptom in the postoperative one week and lasted for 3 months later.2. Changes of plasm motilin concentration: The plasm concentration of motilin in the vagotomy group were increased obviously at postoperative one week and one month, P<0.01. The concentration of motilin in gastrectomy group was higher apparently at postoperative one week, one month and three months than that of motilin preoperatively, P<0.01. The concentration in vagotomy and gastrectomy groups were higher obviously than that of the control group at postoperative one week, P<0.01. The concentration in vagotomy was higher than that in control group at postoperative one month, P<0.05. The concentration in gastrectomy was higher than that in the control group, P<0.01.3. Changes of plasm gastrin concentration: The plasm concentrations of gastrin in both the vagotomy group and the gastrectomy group were increased obviously at postoperative one week, one month and three months, P<0.01. There was no significant difference at the preoperative concentration not only in the vagotomy group and gastrectomy group but also in the control group, P>0.05.4. Changes of the EGG slow wave frequency: The frequency in both the vagotomy group and the gastrectomy group was increased obviously at postoperative one week, one month and three months, P<0.01. The frequency of vagotomy and gastrectomy group at postoperative one week, one month and three months was higher obviously than that of the control group, P<0.01. 5. Changes of nuclear semi-gastric emptying time: The nuclear semi- gastric emptying time in vagotomy group was increased obviously at postoperative one week, one month and three months, P<0.01. The nuclear semi-gastric emptyi...