Time‐Dependent Recovery of Gastric Emptying After Gastrectomy: A 12‐Month Longitudinal Study Using a 13C‐Acetate Breath Test With a Semi‐Solid Meal

TL;DR

This study tracks how gastric emptying changes over a year after gastrectomy surgery for gastric cancer, finding that it initially slows but then speeds up, with differences based on the type of surgery.

Contribution

The study introduces a novel semi-solid meal integrated with a 13C-acetate breath test to longitudinally assess gastric emptying recovery after gastrectomy.

Findings

Gastric emptying half-time (T1/2) was delayed at 1 month post-surgery but significantly improved by 6 and 12 months.

Distal gastrectomy with Billroth I or Roux-en-Y reconstruction showed marked improvement in T1/2 over time.

Proximal and total gastrectomy showed consistently rapid gastric emptying at all time points.

Abstract

Gastric emptying dysfunction is a major concern after gastrectomy for gastric cancer; however, its long‐term course and relationship with surgical procedures remain unclear. This study aimed to evaluate gastric emptying function longitudinally over 12 months postoperatively using the 13C‐acetate breath test with a semi‐solid meal.

A prospective cohort of 95 patients who underwent curative gastrectomy for gastric cancer between April 2021 and July 2024 was assessed. A novel semi‐solid test meal, integrated with a 13C‐acetate breath test, was used to evaluate patients' gastric emptying function. Gastric emptying half‐time (T1/2) was measured preoperatively and at 1, 6, and 12 months postoperatively. Patients were stratified according to surgical procedure and reconstruction method.

The median T1/2 was 42.0 min preoperatively, delayed to 45.9 min at 1 month, and then significantly decreased to 23.4 min at 6 months and 18.7 min at 12 months postoperatively. In distal gastrectomy with Billroth I or Roux‐en‐Y reconstruction, T1/2 was prolonged at 1 month but improved markedly at 6 and 12 months. In contrast, proximal gastrectomy with modified side‐overlap esophagogastrostomy and total gastrectomy showed consistently rapid gastric emptying at all time points.

Gastric emptying function after gastrectomy demonstrated dynamic, time‐dependent changes, with an initial postoperative delay followed by significant acceleration within the first year. The pattern and degree of change differ depending on the surgical procedure and reconstruction method. These findings highlight the importance of individualized, and time‐adapted nutritional management after surgery in patients with gastric cancer.

This study examined time‐dependent changes in gastric emptying after gastrectomy for gastric cancer using a 13C‐acetate breath test with a semi‐solid meal in 95 patients, revealing that gastric emptying was initially delayed at 1 month but significantly accelerated by 12 months postoperatively. The patterns and degree of change differed by surgical procedure and reconstruction method, highlighting the importance of individualized, time‐adapted nutritional management after gastrectomy.

Figures