[Different procedures of alimentary tract reconstruction after subtotal distal gastrectomy in dogs]

To explore an ideal procedure of alimentary tract reconstructions after subtotal distal gastrectomy.

Thirty-two healthy adult beagle dogs were randomly divided into experimental groups A, B, C and control group (n=8). Groups A, B, C operated by subtotal distal gastrectomy underwent 3 different reconstruction methods: continual jejunal interposition (CJI), Billroth II and Roux-en-Y. The control group received a sham operation. Dogs were observed for 12 weeks post-operation. The different parameters of body weight, food intake, PNI (prognostic nutritional index) and peripheral blood concentration of ghrelin were measured in 4 groups.

The body weight, food intake and PNI in Groups A, B, C decreased significantly at post-operation versus pre-operation. There was a slow elevation of body weight, food intake and PNI at Week 12. Group A was significantly better than Groups B and C (P<0.05) while there was no significant difference between Groups B and C. The plasma ghrelin concentrations in Groups A, B, C were significantly reduced at Day 1 post-operation versus pre-operation. But no difference was observed among Groups A, B and C. However an elevated ghrelin concentration was observed at Week 1 post-operation. At Week 12 post-operation, the plasma ghrelin concentration in Group A increased significantly versus Groups B and C (both P<0.05). However, the plasma ghrelin concentration, food intake and PNI were not significantly changed in control group (P>0.05).

The CJI reconstruction procedure is ideally suited for the preservation of duodenal passage after subtotal distal gastrectomy. Subsequently it leads to a significant elevation of circulating ghrelin concentration and a rapid post-operative recovery of food intake, body weight and PNI.