Pathophysiology after pancreaticoduodenectomy

Table 1 Experimental study showing the relationship between motilin and duodenectomy

Ref.	Year	Study design and model	Primary end point	Observations
Tanaka et al[74]	1987	Normal dog vs Duodenectomized dog	Phase III contraction, plasma level of motilin	All control dogs showed characteristic MMC Duodenectomized dog showed non-typical, irregular and non-cyclic pattern of contraction Duodenectomized dog showed low plasma concentration of motilin without cyclical variation
Tanaka et al[75]	1988	Normal dog vs Duodenectomized dog	Inter-digestive gastric and small intestinal MMC plasma level of motilin and Polypeptide Y	MMC was abolished in duodenectomized dogs (3 out of 4 dogs) The other dogs showed intermittent cyclic, but markedly abnormal characteristics of gastric contraction Jejunal MMC appeared with short interval Duodenectomy abolished cyclic variation of plasma motilin and polypeptide Y
Suzuki et al[76]	2001	Conscious dog vs Duodenectomized dog	Phase III contraction, plasma level of insulin, and motilin	Duodenectomy resulted in no phase III contraction in upper GI tract Duodenectomy resulted in no fluctuation of plasma motilin (low level of motilin) Exogenous administration of motilin resulted in comparable response of phased III as shown in control
Malfertheiner et al[77]	1989	Normal dog vs	Pancreatic trypsin	In duodenectomized dog
		Duodenectomized dog	GI motility plasma motilin, PPY	Trypsin secretion was not coordinated with inter-digestive motility, motilin, and PPY Inter-digestive motility was altered Plasma level of motilin and PPY were reduced, and showed no cyclic pattern
Itoh et al[78]	1976	Normal dog	GI motility plasma motilin	Gastrointestinal contractile activity in the conscious dog, Digestive states: motilin had no influence upon the motor activity Inter-digestive states: had influence upon the motor activity
Vantrappen et al[79]	1979	Human	GI motility plasma motilin level	The effect of exogenous motilin on interdigestive migrating motor complex Plasma motilin levels is one of the factor involved in the production of the activity front of the MMC in man
Sarna et al[80]	1983	Normal dog	Plasma motilin levels Migrating myoelectric complexes (MMCs)	Cause and effect relationship between plasma motilin levels and migrating myoelectric complexes Endogenous motilin does not initiate spontaneous mmcs MMC contractions release motilin

GI: Gastrointestinal.