Duodenal interdigestive migrating motor complex in patients 5 years or more after pylorus-preserving gastrectomy for early gastric cancer.

Abstract

We investigated the relationship between interdigestive migrating motor complex, phase III (IMMC-pIII) and postoperative quality of life (QOL) in pylorus-preserving gastrectomy (PPG) patients. A total of 40 patients (26 men and 14 women; average age 59.4 years) 5 to 7.5 years after PPG for early gastric cancer (Billroth I) (average 6 years and 3 months) were divided into two groups according to the occurrence of IMMC-pIII from the duodenum, and their postoperative quality of life (QOL) was compared. As for appetite, "No change compared with before operation" was significantly more frequent in the IMMC-pIII positive group compared with the negative group (P=0.0002). Food consumption per meal compared with normal; "80% or more" was significantly more frequent in the IMMC-pIII positive group than the negative group (P=0.0002). Body weight loss during 5 years after surgery; "6 kg or more" was significantly more frequent in the IMMC-pIII negative group than the positive group (P=0.0002). Early dumping symptoms did not occur in any patients of either group. Reflux esophagitis and nausea; no patients in the IMMC-pIII positive group experienced these symptoms, which was significantly different from the negative group (P=0.0018). Abdominal pain occurred but was significantly less frequent in the IMMC-pIII positive group than in the negative group (P=0.0023). Epigastric fullness occurred but was less frequent in the IMMC-pIII positive group compared with the negative group (P<0.0001). Gastric stasis of the remnant stomach was significantly more frequent in the IMMC-pIII negative group than in the positive group (P<0.0001). Gholelithiasis was significantly more frequent in the IMMC-pIII negative group than in the positive group (P=0.0119). These results showed more satisfactory QOL in the IMMC-PIII positive group than in the negative group.