Delayed gastric emptying after Billroth I pylorus-preserving pancreatoduodenectomy - Effect of postoperative time and cisapride

Objective To study the recovery course of gastric emptying after Billroth I pylorus-preserving pancreatoduodenectomy (PPPD) and therapeutic effects of cisapride. Methods To examine gastric emptying, acetaminophen was given, admixed in a pasty liquid meal, to 16 patients undergoing PPPD before surgery and at 1, 3, 6, 9, and 12 months after surgery. Cisapride was given orally to 10 pati ents before they received the acetaminophen regimen. Electrogastrography wa s per formed at 2 weeks to 1 month after surgery in eight patients and at 6 to 12 months after surgery in seven patients. Results Gastric emptying was delayed but returned to the preoperative level by Ei months after surgery. Pretreatment with cisapride accelerated gastri c emptying during months 1 to 6 but not during months 6 to 12 after surgery . Electrogastrography frequently showed tachygastria 2 weeks to 1 month aft er surgery, but seldom 6 to 12 months after surgery. Conclusions After Billroth I PPPD, gastric emptying is delayed but recovers by 6 months after surgery. Tachygastria may play a part in the pathogenesi s of delayed gastric emptying, but it can be treated with cisapride.