Pyloroplasty improves long-term gastric emptying in rats undergoing fundoplication

Background: Conflicting reports exist regarding the permanence of improved gastric emptying (GE) after fundoplication for gastroesophageal reflux in children. Methods: Changes in gastric volume (GV) and GE of a radiolabeled mixed meal induced by a Nissen fundoplication (NF) were compared with those with a NF plus pyloroplasty (NF + P). GE was measured preoperatively, 15 and 30 days postoperation, in 24 Sprague-Dawley rats; 12 had NF alone, and 12 had NF + P. Results were expressed as percent gastric retention at 90 minutes (GR(90)). GV was measured at the same time periods in 20 additional rats. Results: NF rats had enhanced GE with reduction of preoperative GR(90) from 37.6% to 23.7% at 15 days (P < .05); however, at 30 days the GR90 increased to 34.3%. NF + P rats had enhanced GE with reduction in GR(90) from 37.2% to 20.8% at 15 days (P < .05), which persisted at 30 days (20.4%), Mean GV decreased from (1.36 mL/100 g body weight) preoperation to 0.86 at 15 days (P < .05) at 15 days in the NF group, and returned to 1.29 at 30 days. Mean GV decreased from 1.36 to 0.91 at 15 days in the NF + P rats and persisted at 0.90 at 30 days. Conclusion: In the rat model, NF enhances GE transiently, whereas NF + P produces long-term enhancement of GE. Copyright (C) 2000 by W.B. Saunders Company.