Assessment of delayed gastric emptying after major hepatectomy using a 13C-acetic acid breath test

• Published in: Surgery today (Tokyo, Japan) Japan), 2012-11, Vol.42 (11), p.1046-1050
• Main Authors: Sugimachi, Keishi, Shirabe, Ken, Tokunaga, Noriko, Akiho, Hirotada, Taketomi, Akinobu, Soejima, Yuji, Gion, Tomonobu, Nakamura, Kazuhiko, Higashi, Hidefumi, Maehara, Yoshihiko
• Format: Article
• Language: English
• Subjects: Acetic Acid; Adult; Aged; Breath Tests - methods; Carbon Radioisotopes; Cohort Studies; Dumping Syndrome - diagnosis; Dumping Syndrome - etiology; Female; Gastric Emptying; Hepatectomy - adverse effects; Hepatectomy - methods; Humans; Laparotomy - adverse effects; Laparotomy - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Postoperative Care - methods; Postoperative Complications - diagnosis; Preoperative Care - methods; Prospective Studies; Sensitivity and Specificity; Statistics, Nonparametric; Surgery; Surgical Oncology; Time Factors; Young Adult
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-012-0321-7

Purposes Delayed gastric emptying (DGE) after hepatectomy affects the quality of life of patients, although the causes and related conditions have not been investigated. This study evaluated the relationship between hepatectomy and DGE by the objective assessment of gastric emptying (GE). Methods Nineteen patients who underwent major hepatectomy were prospectively enrolled in the study. Their GE was studied using the 13 C-acetic acid breath test before and after hepatectomy. The results of the GE analysis were correlated with the postoperative course after hepatectomy. Results Clinically evident DGE, which was defined as the inability to take in an appropriate amount of solid food orally by postoperative day 14, was not found in these patients, but the gastric half-emptying times before and after hepatectomy were 20.2 ± 9.7 and 28.6 ± 12.2 min, respectively ( P  = 0.01). The GE time was significantly delayed in patients aged ≥41 years, or who underwent right hemihepatectomy. Conclusions Gastric emptying was significantly inhibited in patients who underwent major hepatectomy, and aging and a right-sided hemihepatectomy may be related to the development of DGE.