An Experimental Study Between Side-To-Side And End-To-Side Gastrojejunostomy After Distal Gastrectomy In Rats

Objective : To establish the model of rats with Roux-en-Y reconstruction after distal gastrectomy,Comparing two methods of gastrojejunostomy between side-to-side and end-to-side anastomosis.Evaluating the gastric emptying rate,blood biochemistry,inflammatory cytokine,and c-kit expression in order to find the difference and possible mechanisms.Methods: SD rats aged 8 weeks were randomly allocated to 3 groups(sham operation group,side-to-side group,and end-to-side group).Only exploratory laparotomy was performed in the sham group.Side-to-side group was performed by side-to-side gastrojejunostomy and end-to-side group was performed by end-to-side gastrojejunostomy with Roux-en-Y reconstruction after distal gastrectomy.On the 10 th day after the operation,blood was collected,gavage and execution were performed.Gastric tissue was retained for further examination.Blood samples were collected for enzyme-linked immunosorbent assay of blood glucose,albumin,motilin,ghrelin,and inflammatory factors.The semi-solid paste was given by quantitative gavage to evaluate gastric emptying rate(20min after gavage).The acetylcholine,nitric oxide and c-kit expression were measured in stomach tissue.Results: A significant increase was observed in the side-to-side group compared with end-to-side group(P<0.05)in the gastric emptying rate.Side-to-side group had a longer operation duration time than end-to-side group(P<0.05).The side-to-side group was significantly higher than end-to-side group(P<0.05)in ghrelin,motilin,and heme oxygenase-1.The side-to-side group was less than end-to-side group(P<0.05)ininterleukin-1β.The albumin,substance P,vasoactive intestinal peptide,interleukin-6,acetylcholine and c-kit expression had no significant difference between side-to-side group and end-to-side group(P>0.05).Conclusion: Side-to-side gastrojejunostomy was better than end-to-side gastrojejunostomy in gastric emptying rate.This difference was attributed to relatively high level of motility hormones(ghrelin,motilin),low level of inflammatory damage(interleukin-1β),and superior anti-inflammatory protective effects(heme oxidase-1).However,it was not related to albumin,substance P,vasoactive intestinal peptide,interleukin-6,acetylcholine,tissue nitric oxide synthase and relative expression of C-kit.