Effects of partitioning operations on the electrical activity of the human stomach

Abstract

To identify the effects that various gastric partitioning procedures have on the electrical activity of the stomach, pairs of bipolar Teflon-coated electrode wires were placed in selected sites of the stomach of 18 patients. Recordings from the proximal gastric fundus above the staple line, from the distal fundus below the staple line, and from the distal gastric antrum were obtained using differential preamplifiers, an oscilloscope, and a dual-channel tape recorder. Oscilloscopic displays were photographed and the electrical signals were recorded for subsequent analysis. The total number of readings at each recording site were: proximal fundus, 79; distal fundus, 59; and antrum, 96. Control electrical rhythm (CER) was found in all the 96 antral recordings. The mean period was 21.6 ± 0.22 sec (SEM). The frequency was 2.8 ± 0.03/min. Only in 4 of the 138 recordings from the gastric fundus, could a low-amplitude CER be identified. Although partitioning of the stomach by stapling produces some degree of crushing injury to the gastric wall, no abnormalities of the CER were noted in the antrum, supporting the concept that the gastric pacemaker of the slow-wave electrical activity (CER) in the human stomach is located below the gastric fundus. Furthermore, in contrast to cardiac muscle, localized mechanical injury to the gastric wall did not result in ectopic foci of electrical activity.