Effect of Rikkunshito, a Chinese Herbal Medicine, on Stasis in Patients After Pylorus-Preserving Gastrectomy

Background Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) have been employed for gastric cancer, with PPG having been reported to be superior to DG in regard to postoperative quality of life. Some patients with these operations still suffer from gastric stasis, however. In this study, we aimed to examine the clinical effects of rikkunshito on patients who were to undergo PPG. Methods A total of 11 patients who were scheduled to undergo PPG for early gastric cancer at the Osaka University Hospital were enrolled. The patients were randomly assigned to the crossover study with and without rikkunshito 7.5 g/day. Questionnaires and emptying tests using In-111-labeled liquid scintigraphy and Tc-99m-labeled solid scintigraphy were performed at the end of each treatment period. Results Stasis-related symptoms were significantly reduced during rikkunshito treatment (p = 0.043). The emptying test showed that rikkunshito improved emptying of solid meals (p = 0.0003) from the remnant stomach but did not accelerate gastric empting of liquid meals. Conclusions Rikkunshito improved gastric emptying and ameliorated postoperative symptoms of patients who had undergone a PPG.