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.