P Maruna1, R Frasko, J Lindner. 1. Institute of Pathological Physiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic. maruna@LF1.cuni.cz
Abstract
BACKGROUND: The aim of the present study was to characterize the disturbances of gastric electrical control activity after cholecystectomy and to correlate electrogastrographic (EGG) findings with inflammatory markers. PATIENTS AND METHODS: 52 adult patients were examined in conjunction with planned laparotomic or laparoscopic cholecystectomy. Gastric myoelectrical activity was recorded with a MicroDigitrapper device using three Ag-AgCl disposable skin electrodes. The dominant frequency was calculated using computerized algorithms. Repeated EGG records were correlated with inflammatory parameters - interleukin-6 (IL-6), tumor necrosis factor-alpha, procalcitonin, and C-reactive protein. RESULTS: Both basal and stimulated gastric electrical frequency decreased significantly in the postoperative phase measured 6 h after the start of surgery (p < 0.01). Postoperative bradygastria (electrical control activity frequency <2.4 cpm) was relatively more expressed after open cholecystectomy. Among the patients with a laparotomic cholecystectomy, IL-6 maximal postoperative concentrations correlated positively with a prolonged restitution of normal gastric activity. CONCLUSIONS: EGG examination showed a high sensitivity in the evaluation of gastric electrical activity after both laparotomic and laparoscopic cholecystectomy. A significant correlation of prolonged bradygastria and IL-6 plasma levels supports the role of the inflammatory milieu in the pathogenesis of impaired gastric electrical activity in the postoperative period. 2009 S. Karger AG, Basel.
BACKGROUND: The aim of the present study was to characterize the disturbances of gastric electrical control activity after cholecystectomy and to correlate electrogastrographic (EGG) findings with inflammatory markers. PATIENTS AND METHODS: 52 adult patients were examined in conjunction with planned laparotomic or laparoscopic cholecystectomy. Gastric myoelectrical activity was recorded with a MicroDigitrapper device using three Ag-AgCl disposable skin electrodes. The dominant frequency was calculated using computerized algorithms. Repeated EGG records were correlated with inflammatory parameters - interleukin-6 (IL-6), tumor necrosis factor-alpha, procalcitonin, and C-reactive protein. RESULTS: Both basal and stimulated gastric electrical frequency decreased significantly in the postoperative phase measured 6 h after the start of surgery (p < 0.01). Postoperative bradygastria (electrical control activity frequency <2.4 cpm) was relatively more expressed after open cholecystectomy. Among the patients with a laparotomic cholecystectomy, IL-6 maximal postoperative concentrations correlated positively with a prolonged restitution of normal gastric activity. CONCLUSIONS: EGG examination showed a high sensitivity in the evaluation of gastric electrical activity after both laparotomic and laparoscopic cholecystectomy. A significant correlation of prolonged bradygastria and IL-6 plasma levels supports the role of the inflammatory milieu in the pathogenesis of impaired gastric electrical activity in the postoperative period. 2009 S. Karger AG, Basel.