caa a22 4500 475801210 CHVBK 20180406123737.0 cr unu---uuuuu 170329e20000101xx s 000 0 eng 10.1007/s002689910016 doi (NATIONALLICENCE)springer-10.1007/s002689910016 Gastric Acidity following Pancreaticogastrostomy with Pylorus-preserving Pancreaticoduodenectomy [Elektronische Daten] [Hiroyuki Shinchi, Sonshin Takao, Shigeho Maenohara, Takashi Aikou] Pancreaticogastrostomy (PG) has been reintroduced and employed occasionally as a useful alternative to pancreaticojejunostomy (PJ) after Whipple resection or pylorus-preserving pancreaticoduodenectomy (PPPD). Although the physiologic alteration in the stomach is important for the correlation between gastric and pancreatic functions, the actual intragastric pH profile after PG is still unclear. This study was conducted to investigate the physiologic changes in gastric pH and serum gastrin and secretin levels before and after PPPD reconstructed with PG (PPPD-PG) in humans. Twenty-four hour continuous intragastric pH and serum gastrin and secretin levels in the fasting state were examined in 25 patients who had undergone PPPD-PG. No peptic ulcer was detected after the operation. After PG, serum gastrin and secretin levels were unchanged. Twenty-four hour gastric pH monitoring revealed two distinct patterns during the nocturnal period before the operation: patients with acid-type secretion (n= 11) exhibited a persistent acid pH, whereas those with alkaline-type secretion (n= 14) had cyclic variations between an acid and an alkaline pH value. After PG, in both acid- and alkaline-type patients, median pH and percentages of time that the gastric pH was less than 4 (% pH < 4) and more than 6 (% pH > 6) did not change, and circadian pH patterns also remained unchanged. These results suggest that PPPD-PG has little influence on gastric acidity, and the neurohumoral relation between the stomach, duodenum, and pancreas is preserved after PG. Therefore, physiologically, PG can be recommended as a reconstructive procedure after PPPD. by the Société Internationale de Chirurgie, 2000 Shinchi Hiroyuki First Department of Surgery, Kagoshima University School of Medicine, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan, JP aut Takao Sonshin First Department of Surgery, Kagoshima University School of Medicine, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan, JP aut Maenohara Shigeho First Department of Surgery, Kagoshima University School of Medicine, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan, JP aut Aikou Takashi First Department of Surgery, Kagoshima University School of Medicine, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan, JP aut World Journal of Surgery Springer-Verlag 24/1(2000-01-01), 86-91 0364-2313 24:1<86 2000 24 268 https://doi.org/10.1007/s002689910016 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689910016 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shinchi Hiroyuki First Department of Surgery, Kagoshima University School of Medicine, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan, JP aut NATIONALLICENCE 700 1- Takao Sonshin First Department of Surgery, Kagoshima University School of Medicine, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan, JP aut NATIONALLICENCE 700 1- Maenohara Shigeho First Department of Surgery, Kagoshima University School of Medicine, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan, JP aut NATIONALLICENCE 700 1- Aikou Takashi First Department of Surgery, Kagoshima University School of Medicine, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan, JP aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/1(2000-01-01), 86-91 0364-2313 24:1<86 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer