Delayed gastric emptying and intestinal hormones following pancreatoduodenectomy

Lisa Strömmer, Sari Räty, Rene Hennig, Thomas E. Adrian, Helmut Friess, Ylva Böttiger, Juozas Stanaitis, Isto Nordback, Juhani Sand, Urban Arnelo

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)

Abstract

Background/Aims: Delayed gastric emptying (DGE) is frequently reported in patients following pancreatoduodenectomy (PD). The present study tested the hypothesis that gastrointestinal hormones known to effect gastric emptying contribute to DGE in patients after PD, Methods: Patients with (delayed, n = 9) or without clinical signs of DGE (non-delayed, n = 22) after PD were investigated. Plasma concentrations of motilin, glucagon-like peptide-1 (GLP-1), neurotensin, and peptide YY (PYY) and the gastric emptying rate (GER), assessed by the paracetamol absorption method were measured after a liquid meal on postoperative day 11. Results: Days with a nasogastric tube (p < 0.01), days until solid food was tolerated (p < 0.05), and hospital stay (p < 0.001) were increased in delayed compared to non-delayed patients. The total and incremental integrated peptide responses of motilin and GLP-1 were similar, but the responses of neurotensin and PYY were reduced, in delayed compared to non-delayed patients, whether considered on clinical grounds or by measured GER (p < 0.05-0.005). Conclusion: Neurotensin and PYY slow the rate of gastric emptying in humans. Therefore, our findings suggest that reduced hormone responses were the consequence of DGE arising from delayed delivery of nutrients to the distal intestine where the endocrine cells secrete neurotensin and PYY reside.

Original languageEnglish
Pages (from-to)537-544
Number of pages8
JournalPancreatology
Volume5
Issue number6
DOIs
Publication statusPublished - 2005
Externally publishedYes

Keywords

  • Delayed gastric emptying
  • Intestinal hormones
  • Pancreatoduodenectomy
  • Paracetamol absorption test

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Gastroenterology

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