RECOVERY OF GASTROINTESTINAL-TRACT MOTILITY AND MYOELECTRIC ACTIVITY CHANGE AFTER ABDOMINAL-SURGERY

Objective: To investigate the relationship between fed-state gastroint estinal tract (GI) function and upper GI myoelectric changes seen afte r abdominal surgery. Design: Twenty-one adult female mongrel dogs unde rwent either an open cholecystectomy, a laparoscopic cholecystectomy a lone, or a laparoscopic cholecystectomy with peritoneal injury (n=7 fo r each group). Bipolar recording electrodes were placed on the antrum and 3 sites of the proximal small intestine to record fasting myoelect ric data each morning postoperatively. Solid-phase, technetium Tc99m g astric emptying studies were performed on postoperative days 1 and 2. Radiopaque markers were ingested just before operation, and the excret ed markers were counted using xray films of the feces. Main Outcome Me asures: Postoperative fasting GI myoelectric activity, gastric emptyin g, and intestinal transit time. Results: Migrating motor complexes (MM Cs) in the small intestine were observed in 33.3% and 75.0% of the dog s on postoperative days 1 and 2, respectively. Gastric dysrhythmias we re observed in 23.8% and 45.0% of the dogs on postoperative days 1 and 2, respectively. No relationship between type of surgery and the pres ence of MMCs or gastric dysrhythmias was noted. Gastric emptying was d elayed on postoperative day 1 and was unrelated to the presence of MMC s. Transit time was not significantly delayed in dogs without MMCs on postoperative day 1 compared with that in dogs with MMCs on that day. The presence of gastric dysrhythmias did not affect transit time studi es. Conclusion: Fasting GI myoelectric activity, including the return of MMCs and the presence of gastric dysrhythmias, does not accurately predict fed-state gastrointestinal GI function following abdominal sur gery.