ERYTHROMYCIN IMPROVES EMPTYING OF THE DENERVATED STOMACH AFTER ESOPHAGECTOMY

Oesophagectomy, necessitating vagotomy, is associated with delayed gas tric emptying. Cisapride and erythromycin have prokinetic effects and improve emptying of the innervated stomach. Their effect on the denerv ated stomach following oesophagectomy is unknown. The effect of pyloro plasty, cisapride and erythromycin on the rate of gastric emptying aft er oesophagectomy was studied using a radiolabelled meal. Oesophagecto my was associated with a marked delay in gastric emptying (56 per cent of the test meal remaining after 4 h) compared with age- and sex-matc hed normal controls (16 per cent; P < 0.001). Erythromycin improved th e rate of gastric emptying to preoperative control values (18 per cent ). Cisapride had no significant effect on gastric emptying. After pylo roplasty, 32 per cent of the label remained at 4 h (P = 0.065). The me an(s.e.m.) half-emptying time in patients receiving erythromycin was 9 4(29) min, which was similar to control values, 55(3) min (P = 0.26). Erythromycin may have a role in the treatment of gastric stasis follow ing oesophagectomy or truncal vagotomy.