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Background/aims: Stress can delay gastric emptying rate. This phenomenon has not yet been investigated with a physiological solid test meal or a regional analysis., Methodology: We investigated the gastric emptying rate in beagle dogs using a radio-labeled solid test meal and a gamma camera. The transport to an unknown environment served as a stress stimulus. This offers the advantage to mimic fairly well the clinical situation just before a diagnostic or therapeutic procedure. Control values were obtained after the third investigation, in which all dogs were accustomed to the environment., Results: Regional analysis of the emptying curves from the whole gastric region revealed that the length of the lag phase increased with stress, but the post-initial emptying rate remained unchanged. Emptying of the fundus changed hardly, but the antropyloral motor activity decreased during stress., Conclusions: Gastric emptying rate is impeded during stress. It is necessary to limit the unnatural stress-stimuli, in order to mimic the clinical situation. Measurement techniques that influence directly gastric emptying or act as a stress-stimulus by themselves are undesirable. A radionuclide solid test meal is preferable and a regional analysis reveals the impairment of the antral motility as the mechanism of the delay of gastric emptying.

Background/aims: Gastric emptying rate for solid and for liquid test meals was investigated retrospectively in patients with longstanding epigastric distress after partial gastrectomy, either as primary treatment or after failure of vagotomy for peptic ulcer in order to find an explanation for the postoperative symptoms., Methodology: Radionuclide-labeled liquid and solid test meals were used to evaluate gastric emptying rate, at least one year after surgery., Results: The lag phase for liquid test meals disappeared in all operated patients. Partial gastrectomy usually lead to fast emptying but this resective procedure, if performed after vagotomy, lead to stasis in a significant number of patients. Gastric emptying rate for solids increased in only a few of these symptomatic patients. In most of them however, there was a normal to decreased emptying rate. If a vagotomy had preceded the resective procedure, gastric emptying rate decreased significantly., Conclusions: In all these symptomatic patients, gastric emptying had been disturbed for at least one type of test meal. This makes investigation for both meals necessary, especially since there is a lack of correlation. Furthermore, if vagotomy fails to prevent ulcer recurrence, one should carefully consider all options before performing partial gastrectomy since gastric emptying rate after these consecutive procedures worsens considerably.

Objective: The purpose of this study was to determine if geometrical correction is necessary in the study of gastric emptying rate (GER) for liquids, using a low-energy radionuclide, such as 99mTc. Solid test meals were considered the reference., Methods: Both solid and liquid GERs were investigated using regional analysis. Anterior data were compared with geometrically corrected values in 15 dogs and 9 partial gastrectomy patients., Results: Anterior and geometrically corrected measurements differed significantly for solid food in the whole gastric region and in the antrum. Geometrically corrected values differed slightly from anterior data after partial gastrectomy. No difference was found for liquid food. Liquids redistributed much faster than solids within the stomach., Conclusion: Measurement of GER using a single-phase liquid meal does not require geometrical correction. This is due to the rapid intragastric redistribution of the liquid. Geometrical correction for solid food can be omitted only after partial gastrectomy.

Background: In vertical banded gastroplasty (VBG), a small proximal gastric pouch is created, which is believed to fill rapidly and to empty slowly., Methods: In 13 patients who underwent VBG, gastric emptying rate was measured. A radiolabelled solid test meal was used before and 2 weeks after operation. From a region of interest above the whole stomach, the proximal pouch and the distal stomach, half emptying time as well as retention percentage were derived., Results: All patients experienced early satiety and gastric fullness after ingestion of a small test meal. The proximal pouch emptied rapidly. The evacuation of the test meal from the whole gastric region as well as the distal stomach were not altered significantly by the operation., Conclusion: VBG is a safe operation which reduced weight significantly. Early satiety, however, induced by this technique, cannot be explained alone by slow emptying of the proximal pouch. The nature of the outlet of the pouch as well as the behavior of its wall must be considered.