Effects of enteral and parenteral nutrition on gastroenteric hormones and gastric motility after subtotal gastrectomy.

OBJECTIVE

To investigate the effects of enteral nutrition (EN) and parenteral nutrition (PN) on gastric motility and gastroenteric hormones after subtotal gastrectomy.

METHODS

Forty-one patients underwent gastrectomy were randomly divided into EN group (n = 20) and PN group (n = 21). From the first postoperative day to the seventh day, patients received either EN (EN group) or PN (PN group) with isocaloric (84.9 kJ x kg(-1) x d(-1)) and isonitrogenous (0.11 g x kg(-1) x d(-1)) intake. Serum gastrin (GAS), plasma motilin (MTL), and plasma cholecystokinin (CCK) were measured on preoperative day, the first and seventh postoperative day. Electrogastrography (EGG) was measured on preoperative day and the seventh postoperative day.

RESULTS

Compared with preoperation, blood GAS, MTL, and CCK levels of 41 patients decreased significantly on the first day after subtotal gastrectomy (P < 0.001), but returned to the preoperative levels one week later. EGG after gastrectomy showed that gastric basal electrical rhythm was significantly restrained (P < 0. 001). On the seventh day after subtotal gastrectomy, plasma MTL and CCK levels in EN group were higher than those in PN group (P < 0.05). There was no difference in GAS level between two groups. EGG in EN group was better than that in PN group postoperatively.

CONCLUSIONS

The levels of gastroenteritic hormones and the gastric motility decrease significantly after subtotal gastrectomy. In contrast with PN, EN can accelerate the recovery of MTL, CCK, and gastric motility after subtotal gastrectomy.