RECOVERY OF SLOW AND FAST GASTRODUODENOJE JUNAL ELECTRICAL-ACTIVITY AFTER CHOLECYSTECTOMY IN MAN

The re-establishment of regular gastrointestinal electrical activity ( Migrating Myoelectrical Complex - MMC - and slow wave) after cholecyst ectomy for gallstones was investigated in six female patients (50-77 y ears) by means of serosal electrodes implanted in the wall of the antr um, duodenum and jejunum during surgery. Five hour recordings were mad e on the first, third and fifth postoperative days, in patients who we re on a liquid diet. The recordings were made after a twelve hour fast . On the fifth postoperative day, a test meal (250 g yoghurt) was give n to the patients ant its effects on electrical activity were monitore d for 2 hours. Even though MMC were present on the first and third pos toperative days, a detailed study of their origin, the length of the P hase 3 and the speed of gastro-jejunal propagation showed that there e xisted an inhibition of gastric MMC until the fifth postoperative day and that intestinal MMC was slower than normal until the third postope rative day. On the fifth postoperative day, gastric inhibition disappe ared since the length of the Phase 3 of the MMC of the stomach corresp onds to those of the duodenum and jejunum, and the speed of propagatio n corresponded to that in normal subjects. Further, the slow wave freq uency perculiar to each segment studied increased progressively from t he first to the fifth postoperative day and the same was true of the s low waves with superimposed action potentials. In conclusion, not-with standing the presence of MMC from the first postoperative day, it was only on the fifth day that normal coordination was restored and hence that patients were able to eat again.