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Ectopic jejunal pacemakers and gastric emptying after Roux gastrectomy: effect of intestinal pacing.
Surgery. 1989 Nov; 106(5):867-71.S

Abstract

The aims of this study were to determine whether ectopic pacemakers are present after meals in the Roux limbs of dogs after vagotomy and Roux gastrectomy, whether these pacemakers slow gastric emptying of liquids or solids, and whether abolishing the pacemakers with electric pacing might speed any slow emptying that occurs. In six dogs that underwent vagotomy and Roux gastrectomy and in four dogs that underwent vagotomy and Billroth gastrectomy (controls), myoelectric activity of the Roux limb or duodenum was measured during gastric emptying of a 500 kcal mixed meal of 99mTc-labeled cooked egg and 111In-labeled milk. Roux dogs were tested with and without pacing of the Roux limb. Roux dogs showed ectopic pacemaker in the Roux limb that drove the pacesetter potentials of the limb in a reverse, or orad, direction during 57% of the postprandial recordings. Billroth dogs had no ectopic pacemakers (p less than 0.05). Liquids emptied more slowly in Roux dogs (half-life (t1/2) = 121 +/- 15 minutes) than in Billroth dogs (t1/2 = 43 +/- 9 minutes; p less than 0.05), but solids emptied similarly in both groups of dogs (t1/2 approximately 8 hours). Pacing the Roux limb abolished the ectopic pacemakers, restored the slow emptying of liquids to the more rapid rate found in the Billroth dogs (t1/2: paced Roux, 72 +/- 15 minutes; Billroth, 43 +/- 9 minutes; p greater than 0.05) and did not change emptying of solids. The conclusion was that ectopic pacemakers present in the Roux limb after vagotomy and Roux gastrectomy drove the limb in a reverse direction and slowed emptying of liquids after the operation. The defect was corrected by pacing the Roux limb in a forward direction.

Authors+Show Affiliations

Department of Surgery, Mayo Clinic, Rochester, Minn. 55905.No affiliation info available

Pub Type(s)

Case Reports
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

2814820

Citation

Karlstrom, L, and K A. Kelly. "Ectopic Jejunal Pacemakers and Gastric Emptying After Roux Gastrectomy: Effect of Intestinal Pacing." Surgery, vol. 106, no. 5, 1989, pp. 867-71.
Karlstrom L, Kelly KA. Ectopic jejunal pacemakers and gastric emptying after Roux gastrectomy: effect of intestinal pacing. Surgery. 1989;106(5):867-71.
Karlstrom, L., & Kelly, K. A. (1989). Ectopic jejunal pacemakers and gastric emptying after Roux gastrectomy: effect of intestinal pacing. Surgery, 106(5), 867-71.
Karlstrom L, Kelly KA. Ectopic Jejunal Pacemakers and Gastric Emptying After Roux Gastrectomy: Effect of Intestinal Pacing. Surgery. 1989;106(5):867-71. PubMed PMID: 2814820.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ectopic jejunal pacemakers and gastric emptying after Roux gastrectomy: effect of intestinal pacing. AU - Karlstrom,L, AU - Kelly,K A, PY - 1989/11/1/pubmed PY - 1989/11/1/medline PY - 1989/11/1/entrez SP - 867 EP - 71 JF - Surgery JO - Surgery VL - 106 IS - 5 N2 - The aims of this study were to determine whether ectopic pacemakers are present after meals in the Roux limbs of dogs after vagotomy and Roux gastrectomy, whether these pacemakers slow gastric emptying of liquids or solids, and whether abolishing the pacemakers with electric pacing might speed any slow emptying that occurs. In six dogs that underwent vagotomy and Roux gastrectomy and in four dogs that underwent vagotomy and Billroth gastrectomy (controls), myoelectric activity of the Roux limb or duodenum was measured during gastric emptying of a 500 kcal mixed meal of 99mTc-labeled cooked egg and 111In-labeled milk. Roux dogs were tested with and without pacing of the Roux limb. Roux dogs showed ectopic pacemaker in the Roux limb that drove the pacesetter potentials of the limb in a reverse, or orad, direction during 57% of the postprandial recordings. Billroth dogs had no ectopic pacemakers (p less than 0.05). Liquids emptied more slowly in Roux dogs (half-life (t1/2) = 121 +/- 15 minutes) than in Billroth dogs (t1/2 = 43 +/- 9 minutes; p less than 0.05), but solids emptied similarly in both groups of dogs (t1/2 approximately 8 hours). Pacing the Roux limb abolished the ectopic pacemakers, restored the slow emptying of liquids to the more rapid rate found in the Billroth dogs (t1/2: paced Roux, 72 +/- 15 minutes; Billroth, 43 +/- 9 minutes; p greater than 0.05) and did not change emptying of solids. The conclusion was that ectopic pacemakers present in the Roux limb after vagotomy and Roux gastrectomy drove the limb in a reverse direction and slowed emptying of liquids after the operation. The defect was corrected by pacing the Roux limb in a forward direction. SN - 0039-6060 UR - https://www.unboundmedicine.com/medline/citation/2814820/Ectopic_jejunal_pacemakers_and_gastric_emptying_after_Roux_gastrectomy:_effect_of_intestinal_pacing_ L2 - https://medlineplus.gov/pacemakersandimplantabledefibrillators.html DB - PRIME DP - Unbound Medicine ER -