Recovery of gastroduodenojejunal electric activity after cholecystectomy. In situ study in mam

Abstract

The recovery of gastrointestinal electrical activity--migrating myoelectrical complex (MMC) and slow waves--was studied in six women (50-77 years) after cholecystectomy for gallstones: serosal electrodes in pairs are implanted in the wall of the antrum, duodenum and jejunum during surgery. Five hour recordings were made on the first, third and fourth postoperative days (pOD), in starvation condition with hydric intake only. The recordings were made after a twelve hour fast. On the fourth postoperative day, a test meal (250 g yogurt) was given to the patients and its effects on electrical activity were recorded for 2 hours. Even though MMC were present on the first and third postoperative days, a detailed study of their origin, the length of the phase 3 and the speed of gastro-jejunal propagation showed an inhibition of gastric MMC until the fourth pOD, moreover that intestinal MMC was slower than normal until the third pOD. On the fourth postoperative day, gastric inhibition disappeared since the length of the phase 3 of the MMC in the gastric level corresponded to those of the duodenum and jejunum. Furthermore the speed of propagation corresponded to that in normal subjects. Further, the slow wave frequency peculiar to each segment studied increased progressively from the first to the fourth pOD just like the slow waves with action potentials. In conclusion, notwithstanding the presence of MMC from the first postoperative day, it was only on the fourth day that normal coordination was restored and hence that patients were able to eat again.