Electrophysiological and mechanical activity of the upper gastrointestinaltract after duodenoplasty or segmental resection of benign gastric outlet stenosis

In an animal experimental study we examined the postoperative recovery of t he motility of the upper gastrointestinal tract after operative treatment o f a benign gastric outlet obstruction. At 45 Days after induction, a duoden al stenosis was resected in six dogs, and resolved by Finney's duodenoplast y in another six dogs. Fourteen days after segmental resection, the gastric emptying was faster [half evacuation time (T1/2) for semisolid food = 44.4 +/- 16.8 min] than following duodenoplasty [T1/2 = 56.8 +/- 25.3). Here mo tor migrating complexes (MMCs) started in the antrum and could be traced do wn to the jejunum. After segmental resection we recognized MMC only distal to the anastomosis. The duration of the whole MMC cycle (69.0 +/- 18.6 min) as well as of the single phases was significantly shorter in the resection group than after duodenoplasty (108.0 +/- 15.1 min). At 28 days after oper ation the differences in the electromyographic findings were smaller (83.0 +/- 15.1 min vs. 111.4 +/- 11.2 min), but still significant. Obviously humo ral transmitters and the extrinsic neural system lead to good propagation o f the MMC across the anastomosis, even before the intramural pathways are r eestablished. Concerning the fast recovery of the motility of the upper gas trointestinal tract, duodenoplasty is superior to segmental duodenal resect ion.