PARTIAL GASTRIC RESECTION FOR PEPTIC-ULCER - COMPARISON OF THE EFFECTOF VARIANT RECONSTRUCTIVE PROCEDURES ON GASTRIC-EMPTYING, GASTRIC-ACID SECRETION AND GASTRIN-RELEASE IN THE EARLY POSTOPERATIVE PERIOD .I. ROUX-EN-Y AND BILLROTH-II GASTROENTEROANASTOMOSIS

Fourteen patients subjected to partial gastric resection with vagotomy and a gastroenterostomy (Roux-en-Y, in 11 patients and of Billroth ty pe-II in 3) underwent examinations of the gastric emptying (GE) of a r adiolabelled solid meal, as well as of gastric acid and gastrin secret ion before surgery and/or within 5.5 weeks postoperatively, The surger y resulted in a significant delay in GE - the median T1/2 nearly doubl ed from 77 min before to 151 min after the operation (p<0.01), The GE pattern did not, however, change significantly, as reflected by a medi an curve shape parameter S amounting to 1.05 and 0.87 before and after the surgery, respectively, The Roux-en-Y reconstruction brought about a pronounced delay in GE with -: T1/2 exceeding the border of the mea n T1/2+2SD of healthy controls in 7 (64%)out of 11 patients. On the ot her hand, no one of the B-II operated patients had a slowed GE, The ba sal and pentagastrin-stimulated gastric acid secretion was decreased b y an average of 71% (from 6.2+/-0.7 to 1.8+/-0.6 mmol h(-1), p<0.001) and 82% (From 25.2+/-3.0 to 4.4+/-1.2 mmol h(-1) p<0.001), respectivel y, The surgery did not affect the Pasting serum gastrin concentration (53.2+/-4.9 pre- vs 51.0+/-11.5 ng, I-1 postoperatively), whereas the postprandial gastrin release decreased significantly - AUC(0-120): 983 8+/-1377 ng, I-1 min before and 6863+/-1024 ng, I(-1)min after the ope ration, p<0.01.