Eur J Pediatr Surg 2008; 18(6): 395-397
DOI: 10.1055/s-2008-1038919
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Gastric Emptying is Accelerated following Laparoscopic Nissen Fundoplication

M. Pacilli1 , A. Pierro1 , K. J. Lindley2 , J. I. Curry1 , S. Eaton1
  • 1Department of Surgery, Institute of Child Health and Great Ormond Street Hospital, University College London, London, UK
  • 2Department of Gastroenterology, Institute of Child Health and Great Ormond Street Hospital, University College London, London, UK
Further Information

Publication History

received June 23, 2008

accepted after revision July 7, 2008

Publication Date:
27 November 2008 (online)

Abstract

Aim of the Study: The effects on gastric motility following Nissen fundoplication in children are poorly documented. Some paediatric surgeons advocate additional procedures at the same time as fundoplication, such as a pyloroplasty, to enhance gastric emptying. The aim of this study was to determine whether laparoscopic Nissen fundoplication without pyloroplasty affects gastric emptying. Methods: Gastric emptying was measured before laparoscopic Nissen fundoplication in 8 children after ingestion of a standardised volume of milk for age mixed with 150 mg of 13C-octanoic acid. None of the patients had a gastrostomy insertion at the time of fundoplication and 2 patients had neurological impairment. Breath samples were collected by breathing into a mask at baseline and every 15 minutes up to 3 hours, and were analysed for 13CO2/12CO2 ratio by mass spectrometry. Gastric emptying time (t1/2) was derived from the curve of 13CO2/12CO2 ratio against time. The test was repeated in 6 children following Nissen fundoplication at the time of full feeds. Data are reported as mean ± SD and were analysed by the Mann-Whitney test. Results and Conclusions: There were 4 males and 4 females; mean age at surgery was 3.3 ± 3.0 years. Mean gastric emptying time was 59 ± 17 min prior to laparoscopic Nissen fundoplication and 45 ± 4 min following surgery (p = 0.03). Gastric emptying was accelerated in all except one patient. Gastric emptying for liquids is accelerated following Nissen fundoplication in children. Procedures aimed at improving gastric emptying time such as pyloroplasty or pyloromyotomy might not be justified at the time of laparoscopic Nissen fundoplication.

References

Dr. Ph.D. Simon Eaton

Department of Surgery
Institute of Child Health

30, Guilford Street

London WC1N 1EH

UK

Email: s.eaton@ich.ucl.ac.uk