PHYSIOLOGICAL-EFFECTS OF CISAPRIDE ON GASTRIC-EMPTYING AFTER PYLORUS-PRESERVING GASTRECTOMY FOR EARLY GASTRIC-CANCER

Pylorus-preserving gastrectomy (PPG) has been considered reasonable re duction surgery. However, even patients in whom more than 1 year passe d after surgery frequently have a feeling of gastric fullness after me als and long-term retention of foods in the residual stomach. To treat this syndrome, cisapride has been administered. We studied the emptyi ng time of a semisolid diet (radioisotope method using Tc-99m-tin coll oid-labeled rice gruel) and the emptying time of a fluid diet (acetami nophen method with orange juice) before and after oral administration of cisapride (15 mg/day for 1 month) in 14 patients (10 men, 4 semen; 32-70 years old, average 60.6 years) who underwent PPG (Billroth I pro cedure, D-2 lymph node dissection, curability A) for treatment of earl y gastric cancer. Ten healthy volunteers without gastrointestinal symp toms and digestive diseases (7 men, 3 women; 28-61 years old, average 49.8 years) were enrolled as controls. The results showed obviously de layed emptying time of the semisolid diet before administration of cis apride in patients with PPG compared with that of the control group, w hereas the emptying curves for the fluid diet showed an almost normal pattern. One month after the start of cisapride administration the emp tying time of the semisolid diet was improved, and the emptying curves were close to the patterns in the control group. Emptying of the flui d diet was slightly accelerated compared with that before administrati on of cisapride, and the emptying curves showed almost the same patter n as in the control group. A postgastrectomy symptom, ''gastric fullne ss,'' after PPG was alleviated by cisapride. These results showed that cisapride improved delayed emptying of a semisolid diet after PPG and prevented the feeling of gastric fullness after meals due to retentio n in the residual stomach.