A new model for improved gastrectomy drainage.

Slow waves in isolated jejunal segments have been shown, in at least two studies, to have an increased percentage of neither prograde nor retrograde progression. Instead the pattern has been characterized as "nonpropagating" by Johnson and Sarna et al., and "chaotic" by others. We compared gastric drainage produced by a Roux-Y created with a single transection, with gastric drainage produced by a Roux-Y created in a jejunal segment isolated between two transections. Theoretically, this avoids the retrograde slow waves produced by a single transection. Ten dogs of either gender were divided into two groups of five. One group was given a truncal vagotomy, hemigastrectomy, and a standard Roux-Y drainage with a single jejunal transection; the other five were given the same operation with a distal jejunal transection and anastomosis 25 cm beyond the jejunojejunostomy (thus creating the Roux-Y in an isolated segment). In the approximate 50-day follow-up, 3 of 5 animals with standard preparations developed considerable difficulty in maintaining nutrition and developed hugely dilated stomachs. Animals with stomachs drained by the isolated jejunal segment Roux-Y had less difficulty maintaining nutrition and experienced minimal gastric dilatation. These findings were confirmed by upper gastrointestinal series at 2 weeks and at autopsy. In conclusion, this study shows that gastric drainage following truncal vagotomy and hemigastrectomy is enhanced by a Roux-Y created in an isolated jejunal segment.

Effect of resuscitation solutions on the immune status of dogs in hemorrhagic shock.

The purpose of this study is to examine the effects of three different types of fluid resuscitation on the immune system of dogs in hemorrhagic shock. Using a modified Wigger shock model, 18 conditioned male dogs were bled to mean arterial blood pressure of 60 mm Hg for 90 minutes and placed into three groups based on the resuscitative method. Group I: Crystalloid Resuscitation; Group II: Autotransfusion; Group III: Banked Blood. Laboratory methods for immune status evaluation included total lymphocyte count, T4/T8 ratio, total serum immunoglobulins, and immunoglobulin electrophoresis. These values were obtained pre-hemorrhagic shock, just before resuscitation, and subsequently on days 1, 4, and 7. Humoral immunity, represented by total serum immunoglobulin levels (IgA, IgG, IgM), was higher in Groups II and III when compared with group I on all post-resuscitation days. IgA and IgM levels were higher in Group III compared with Groups I and II. IgG level was higher in Group II compared with Groups I and III. Cellular immunity was also affected by transfusion. Total lymphocyte count was increased in Group II on Day 1; however, the three groups were similar with respect to this variable on subsequent days. The absolute T4 helper cell level in Group II was similar to Groups I and III until Day 7, at which time the level became higher in Group II.(ABSTRACT TRUNCATED AT 250 WORDS)