PRESERVATION OF NORMAL GASTRIC-EMPTYING FOLLOWING GASTRIC-SURGERY BY USE OF A MUSCLE BRIDGE

BACKGROUND: Maintenance of descending antral intramural pathways may b e important in normal functioning of the pylorus after pylorus-preserv ing gastrectomy.METHODS: We examined the effect of a 1-cm bridge of mu scle as a means of maintaining pyloric connection to antral intramural motor control pathways in 10 pigs. Antropyloroduodenal pressures and transpyloric flow were measured during gastric emptying of saline befo re and after either total or subtotal transection and reanastomosis of antrum. RESULTS: Complete antral transection shortened the time inter val between antral and subsequent pyloric lumen occlusion, significant ly reducing total gastric emptying and volume of transpyloric flow pul ses. Subtotal transection maintained pre-transection timing and was as sociated with normal patterns of transpyloric flow and emptying. CONCL USIONS: Our results indicate that a muscle bridge is capable of mainta ining normal gastric emptying and the coordination of antral with pylo ric contractions. We propose that antropyloric coordination is maintai ned by transmission of neural signals through the muscle bridge.