A Radiologic Method for the Study of Postoperative Colonic Motility in Humans

Abstract

Propulsive colonic motility in the postoperative period was studied, in 49 patients undergoing cholecystectomy, by means of radiopaque markers, water-soluble contrast, and serial abdominal radiographs. The colon was divided into four segments, and the propagation of the markers and contrast to the segments was registered. Marker propagation correlated significantly with the propagation of the contrast to all segments of the colon (p less than 0.001). The first postoperative passage of gas did not correlate significantly with the propagation of the markers or the contrast to the various colonic segments. The first passage of faeces postoperatively did not correlate significantly with the return of propulsive motility in the right colon; however, there was a significant correlation with the propulsion of markers to the descending colon (p less than 0.05) and the rectosigmoid colon (p less than 0.05). The duration of postoperative paralytic ileus, as measured by the start of propagation of the markers from the caecum, correlated directly with the consumption of opiate analgesics in the postoperative period (p less than 0.01) but inversely with age (p less than 0.05). The duration of surgery did not correlate significantly with the duration of paralytic ileus in the colon. In conclusion, a limited number of radiopaque markers can be used to study the return of postoperative propulsive motility in the colon. The first postoperative passage of gas is not an indicator of the duration of postoperative paralytic ileus, whereas the first passage of faeces is primarily representative of the return of propagative motility in the left colon.