ASSESSMENT OF GASTRIC AND GALLBLADDER EMPTYING IN SCHISTOSOMAL PATIENTS BEFORE AND AFTER HASSAB'S DEVASCULARIZATION OPERATION

Document Type : Original Article

Authors

1 Departments of Surgery, Faculty of Medicine, University of Alexandria, Egypt

2 Diagnostic Radiology, Faculty of Medicine, University of Alexandria, Egypt

Abstract

Objectives: Gastric and gallbladder (GB) dysmotility were documented in liver cirrhotic, but the effect of surgery for bleeding gastro-esophageal varices on motility still not clear. This study assessed the effect of Hassab's gastro-esophageal devascularization (GED) operation on gastric and GB motility in schistosomal patients. 
Patients & methods: Thirty schistosomal patients with bleeding varices, who underwent GED operation, were subjected to gastric and GB motility study using ultrasonography, before and after surgery. The results were compared to each other and fifteen matching controls. 
Results: Schistosomal patients had significantly impaired gastric emptying for semisolids, measured by gastric emptying (%) at 30 minutes, and GB emptying, measured by ejection fraction (%), compared to controls (64.67±12.98% Vs. 74.89±12.78%, P=0.016) and (44.47±10.57% Vs. 52.98±8.94%, P=0.011) respectively. Following surgery both gastric and GB emptying were significantly reduced compared to pre-operative values (54.29±14.45% Vs. 64.67±12.98%, P=0.004) and (38.95±9.47% Vs. 44.47±10.57%, P=0.007) respectively. Multivariate analysis revealed that preoperative gastric emptying, Child's grad and variceal grad were the independent predictive factors influencing postoperative gastric emptying, while no factor was identified to influences postoperative GB emptying. 
Conclusion: Schistosomal patients had impaired gastric and gallbladder emptying which became worth after GED operation. Prophylactic measures had to be taken to improve outcome.

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