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We recorded and analyzed electrogastrograms (EGGs) from 12 patients following distal gastrectomy. The EGGs were recorded from between 3 and 262 months post-operatively. Gastric electrical activity, which showed a distinct repeating pattern with a frequency of 3 cycles per minute (cpm), was easily recognizable in subjects who were recorded 16-20 years postoperatively, but was not clearly evident in EGG running spectra of subjects with a shorter postoperative period. Although the postprandial instability factor of the 3-cpm components (standard deviation of mean spectral frequency of peak 3-cpm group/mean of the 3-cpm spectral frequency) of the epigastric and supraumbilical EGGs showed a significant negative linear correlation with postoperative months, no such correlation was seen in the postprandial to fasting power ratio (postprandial power / fasting power) of the 3-cpm activity component. Therefore, we hypothesized that the disorganized pacemaker activity of the remnant stomach following distal gastrectomy can be reorganized to work as a synchronized unit over a long postoperative recovery period of from 15 to 20 years. A greater degree of epigastric and supraumbilical fasting 6-cpm power seemed to result in a worse quality of life (QOL). Similarly, a larger ratio of the supraumbilical postprandial to fasting power ratio of the 6-cpm activity seemed to result in a worse QOL. In contrast a larger ratio of the infaraumbilical postprandial to fasting power content of the 6-cpm activity seemed to result in a better QOL.

Postoperative reorganization of gastric pacemaker activity in patients after an extended period following distal gastrectomy