{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T16:35:59Z","timestamp":1765643759529,"version":"3.48.0"},"reference-count":13,"publisher":"BMJ","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1988,9]]},"abstract":"<jats:p>The pattern of gastric emptying after truncal vagotomy and drainage is usually biphasic. An early rapid phase is followed by a characteristically abrupt transition to slow emptying. The mechanisms responsible for this pattern were studied in six dogs with truncal vagotomy and pyloroplasty, fitted with a proximal duodenal cannula. Gastric emptying was measured using gamma camera imaging of a radiolabelled 15% dextrose test meal. Sixty one hour studies were done using five designs. (1) With the cannula closed gastric emptying was initially rapid, followed by stasis (emptying at 15 min - 32% (5.3), 60 min - 34% (4.8); mean (SE)). (2) With the cannula open emptying was very rapid (15 min - 76% (4.2) p less than 0.001, 60 min - 88% (2.6) p less than 0.001 ANOVA). (3) Distal duodenal instillation of isotonic saline, at a rate equivalent to gastric emptying with the cannula closed, did not retard this rapid emptying (15 min - 78% (10.6), 60 min - 90% (5.4)). (4) With duodenal instillation of 15% dextrose, gastric emptying remained faster than in studies without diversion (15 min - 50% (7.0) NS, 60 min - 65% (6.8) p less than 0.01), but was slower than during diversion alone (p less than 0.05). (5) Finally, duodenal instillation of 15% dextrose before administration of the test meal produced slower initial emptying without subsequent stasis (15 min - 24% (4.5), 60 min - 47% (10.6)), although the amounts emptied were not significantly different from those with the cannula closed. These results indicate that after truncal vagotomy and pyloroplasty small bowel resistances play a significant role in controlling gastric emptying. Osmoreceptor responses persist after truncal vagotomy, but sympathetic inhibitory responses to small bowel distension are not involved in the regulatory process.<\/jats:p>","DOI":"10.1136\/gut.29.9.1253","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"1253-1257","source":"Crossref","is-referenced-by-count":3,"title":["Mechanisms governing the biphasic pattern of gastric emptying after truncal vagotomy and pyloroplasty."],"prefix":"10.1136","volume":"29","author":[{"given":"N J","family":"Parr","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Grime","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Critchley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J N","family":"Baxter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C R","family":"Mackie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1988,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1136\/bmj.2.5864.448","article-title":"Pattern of gastric emptying after vagotomy and pyloroplasty","volume":"ii:","author":"Colmer, M.R.; Owen, G.M.; Shields, R.","year":"1973","unstructured":"Colmer MR, Owen GM, Shields R. Pattern of gastric emptying after vagotomy and pyloroplasty. Br Med J 1973; ii: 448-50.","journal-title":"Br Med J"},{"key":"ref_2","first-page":"215","article-title":"The effect of vagotomy on the solid and liquid components of a meal","volume-title":"Gastrointestinal motility in health and disease","author":"MillarJW, McLoughlin G.P.; IB, MacLeod; RC, Heading","year":"1978","unstructured":"MillarJW, McLoughlin GP, MacLeod IB, Heading RC. The effect of vagotomy on the solid and liquid components of a meal. In: Duthie LH, ed. Gastrointestinal motility in health and disease. Lancaster: MTP Press, 1978: 215-21."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1002\/bjs.1800750330","article-title":"The relationship between'gastric emptying of liquid and post-vagotomy diarrhoea","volume":"75","author":"Parr, N.J.; Grime, S.; Brownless, S.; Critchley, M.; Baxter, J.N.; Mackie, C.R.","year":"1988","unstructured":"Parr NJ, Grime S, Brownless S, Critchley M, Baxter JN, Mackie CR. The relationship between'gastric emptying of liquid and post-vagotomy diarrhoea. Br J Surg 1988; 75: 279-82.","journal-title":"Br J Surg"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1097\/00000658-197309000-00009","article-title":"Effect of proximal gastric, complete gastric, and truncal vagotomy on canine gastric electric activity, motility and emptying","volume":"178","author":"Wilbur, B.G.; Kelly, K.A.","year":"1973","unstructured":"Wilbur BG, Kelly KA. Effect of proximal gastric, complete gastric, and truncal vagotomy on canine gastric electric activity, motility and emptying. Ann Surg 1973; 178: 295-303.","journal-title":"Ann Surg"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1136\/gut.14.4.300","article-title":"The effect of preserving antral innervation and of a pyloroplasty on gastric emptying after vagotomy in man","volume":"14","author":"Clarke, R.J.; Alexander-Williams, J.","year":"1973","unstructured":"Clarke RJ, Alexander-Williams J. The effect of preserving antral innervation and of a pyloroplasty on gastric emptying after vagotomy in man. Gut 1973; 14: 300-7.","journal-title":"Gut"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1002\/bjs.1800650915","article-title":"The relationship between the rate of gastric emptying and the dumping syndrome","volume":"65","author":"Ralphs, D.N.; Thomson, J.P.; Haynes, S.; Lawson-Smith, C.; Hobsley, M.; LeQuesne, L.P.","year":"1978","unstructured":"Ralphs DN, Thomson JP, Haynes S, Lawson-Smith C, Hobsley M, LeQuesne LP. The relationship between the rate of gastric emptying and the dumping syndrome. Br J Surg 1978; 65: 637-41.","journal-title":"Br J Surg"},{"key":"ref_7","first-page":"950","article-title":"The mechanism of the gastroduodenal brake","volume":"28","author":"Parr, N.J.; Grime, J.S.; Critchley, M.; Baxter, J.N.; Mackie, C.R.","year":"1987","unstructured":"Parr NJ, Grime JS, Critchley M, Baxter JN, Mackie CR. The mechanism of the gastroduodenal brake. Gut 1987; 28: 950-4.","journal-title":"Gut"},{"key":"ref_8","first-page":"403","article-title":"Search for resistances controlling canine gastric emptying of liquid meals","volume":"241","author":"Miller, J.; Kauffman, G.; Elashoff, J.; Ohasi, H.; Carter, D.; Meyer, J.H.","year":"1981","unstructured":"Miller J, Kauffman G, Elashoff J, Ohasi H, Carter D, Meyer JH. Search for resistances controlling canine gastric emptying of liquid meals. Am J Physiol 1981; 241: G403-15.","journal-title":"Am J Physiol"},{"key":"ref_9","first-page":"391","article-title":"for measuring gastric emptying time","volume":"15","author":"of 'Tc-D. T. P. A, Chauduri T. Use","year":"1974","unstructured":"Chauduri T. Use of 'Tc-D.T.P.A. for measuring gastric emptying time. J Nucl Med 1974; 15: 391-5.","journal-title":"J Nucl Med"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1152\/ajplegacy.1934.109.1.133","article-title":"The mechanism of gastric motor inhibition from ingested carbohydrates","volume":"109","author":"Quigley, J.P.; Phelps, K.R.","year":"1934","unstructured":"Quigley JP, Phelps KR. The mechanism of gastric motor inhibition from ingested carbohydrates. Am J Physiol 1934; 109: 133-8.","journal-title":"Am J Physiol"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1113\/jphysiol.1978.sp012477","article-title":"Vagal glucoreceptors in the small intestine of the cat","volume":"282","author":"Mei, N.","year":"1978","unstructured":"Mei N. Vagal glucoreceptors in the small intestine of the cat. J Physiol 1978; 282: 485-506.","journal-title":"J Physiol"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1136\/gut.16.5.331","article-title":"The vagus, the duodenal brake, and gastric emptying","volume":"16","author":"Shahidullah, M.; Kennedy, T.L.; Parks, T.G.","year":"1975","unstructured":"Shahidullah M, Kennedy TL, Parks TG. The vagus, the duodenal brake, and gastric emptying. Gut 1975; 16: 331-6.","journal-title":"Gut"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1002\/bjs.1800680205","article-title":"Does osmotic control of gastric emptying persist after truncal vagotomy?","volume":"68","author":"Gough, J.M.; Jumphrey, C.S.; Giles, G.R.","year":"1981","unstructured":"Gough JM, Jumphrey CS, Giles GR. Does osmotic control of gastric emptying persist after truncal vagotomy? Br J Surg 1981; 68: 77-80.","journal-title":"Br J Surg"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.29.9.1253","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T16:35:00Z","timestamp":1765643700000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.29.9.1253"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1988,9]]},"references-count":13,"journal-issue":{"issue":"9","published-online":{"date-parts":[[1988,9,1]]},"published-print":{"date-parts":[[1988,9]]}},"alternative-id":["10.1136\/gut.29.9.1253"],"URL":"https:\/\/doi.org\/10.1136\/gut.29.9.1253","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"type":"print","value":"0017-5749"},{"type":"electronic","value":"1468-3288"}],"subject":[],"published":{"date-parts":[[1988,9]]}}}