Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
MALDIGESTION AFTER TOTAL GASTRECTOMY IS ASSOCIATED WITH PANCREATIC INSUFFICIENCY
Autore:
FRIESS H; BOHM J; MULLER MW; GLASBRENNER B; RIEPL RL; MALFERTHEINER P; BUCHLER MW;
Indirizzi:
UNIV BERN,DEPT VISCERAL & TRANSPLANTAT SURG,INSELSPITAL CH-3010 BERN SWITZERLAND UNIV BERN,DEPT VISCERAL & TRANSPLANTAT SURG CH-3010 BERN SWITZERLAND UNIV ULM,DEPT SURG & GASTROENTEROL ULM GERMANY UNIV MUNICH,KLINIKUM INNENSTADT,DEPT INTERNAL MED MUNICH GERMANY OTTO VONGUERICKE UNIV,DEPT GASTROENTEROL HEPATOL & INFECT DIS MAGDEBURG GERMANY
Titolo Testata:
The American journal of gastroenterology
fascicolo: 2, volume: 91, anno: 1996,
pagine: 341 - 347
SICI:
0002-9270(1996)91:2<341:MATGIA>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
DUODENAL-ULCER PATIENTS; POLYPEPTIDE RESPONSE; CHOLECYSTOKININ RELEASE; SUBTOTAL GASTRECTOMY; EXOCRINE PANCREAS; ENZYME-SECRETION; VAGOTOMY; FOOD; PYLOROPLASTY; SOMATOSTATIN;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
43
Recensione:
Indirizzi per estratti:
Citazione:
H. Friess et al., "MALDIGESTION AFTER TOTAL GASTRECTOMY IS ASSOCIATED WITH PANCREATIC INSUFFICIENCY", The American journal of gastroenterology, 91(2), 1996, pp. 341-347

Abstract

Objectives: Subsequent to total gastrectomy, many patients develop maldigestion and weight lass. The mechanisms that underlie these changesare not known. Therefore, in a prospective study, we have analyzed endocrine and exocrine pancreatic function in patients before and 3 months after total gastrectomy. Methods: In 15 patients (12 male, three female, median age 62.4 yr) undergoing total gastrectomy due to gastric cancer, a direct exocrine pancreatic function test (secretin-cerulein test) was performed. In addition, a standard test meal was given to all patients to study endocrine pancreatic function and the pattern of hormones that influence exocrine pancreatic secretion. In nine patients, both function tests were repeated 3 months after total gastrectomy. Before and at 11 points after the application of the test meal, blood samples were taken for the measurement of glucose, insulin, glucagon, gastrin, pancreatic polypeptide, and cholecystokinin. In addition, a secretin-cerulein test was performed to analyze trypsin, chymotrypsin, amylase, bicarbonate, and the juice volume in the duodenal aspirates. Results: Three months after total gastrectomy, all patients exhibited severe primary exocrine pancreatic insufficiency. Secretin-cerulein tests revealed that pancreatic juice secretion, trypsin, chymotrypsin, and amylase were significantly reduced by 76%, 89%, 91%, and 72%, respectively, 3 months after total gastrectomy and secretin and cerulein stimulation. Postoperatively, the patients had a pathological glucose tolerance with increased postprandial insulin and glucagon secretion. The baseline and postprandial gastrin and pancreatic polypeptide secretion were significantly decreased after total gastrectomy. In contrast, early postprandial cholecystokinin secretion was significantly increased postoperatively. Conclusions: After total gastrectomy, patients develop severe primary exocrine pancreatic insufficiency with decreased gastrin, decreased late postprandial pancreatic polypeptide, and increased cholecystokinin levels. These findings may explain why many patients with total gastrectomy have maldigestion and weight loss postoperatively. Therefore, gastrectomized patients should be given pancreatic enzymes to avoid these symptoms.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 03:31:53