J.Jpn. Surg. Soc.. 57(9): 1513-1526, 1956

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THE MOVEMENTS OF THE SMALL INTESTINE AFTER TOTAL GASTRECTOMY
PART II. MOTOR FUNCTION OF SUBSTITUTE STOMACH FORMED BY TOMODA'S METHOD* OF TOTAL GASTRECTOMY

The loss of the stomach as a reservoire for ingested food is naturally followed by a change in the preoperative physical relation between food and the intestine, making it probable that the motor function of the intestine, particularly of its upper part, may accordingly be altered after total gastrectomy.
The author examined the motor function of the efferent loop of the jejunum interposed between the esophagus and duodenum, of the genu inferius duodeni, and of the part of the jejunum extended from its beginning part to Braun's anastomosis, by tracing the internal pressure of those parts of the small intestine by means of a balloon inserted there from the mouth in 18 patients subjected to total gastrectomy by Tomoda's method from 5 months to 5 years and 5 months previously. The kymographical records of the internal pressure showed the following facts :
1) In 8 of 11 cases the genu inferius duodeni was in periodical movements, a period of strong movements and a period of weak movements following each other and a few minutes' tonic rise occurrring towards the termination of a period of strong movements.
2) In 9 of 11 cases the efferent loop of the jejunum was in periodical movements, a period of strong movements and a period of weak movements following each other and a few minutes' tonic rise occurring towards the end of a period of strong movements.
3) In 5 of 6 cases part of the jejunum which lies between its beginning part and Braun's anastomosis was in periodical movements, a period of strong movements and a period of weak movements following each other and a few minutes' tonic rise occurring towards the end of a period of strong movements.
4) The fact that parts of the intestine which form a substitute stomach resemble the stomach in the periodicity of movements appears to indicate that those parts of the intestine, directly connected to the esophagus, undergo some functional change to adapt itself to their new environment under the necessity of taking in a large quantity of food direct from the esophagus.
(author's abstract)

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