Gastric Emptying of Liquid Meals and Pancreatic and Biliary Secretion After Subtotal Gastrectomy or Truncal Vagotomy and Pyloroplasty in Man
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Pancreatic and biliary secretion and gastric emptying rates of a liquid test meal (LTM) were determined in normal persons, in patients with subtotal gastrectomy with gastroduodenostomy (STG-BI) or with gastrojejunostomy (STG-BII), and in patients with truncal vagotomy and pyloroplasty (V&P). In all operated persons, rapid gastric emptying diluted intraluminal contents, with consequent abnormally low concentrations of trypsin and bile salts initially, a pattern that was not corrected by addition of intravenous hormones to the meal stimulus. Trypsin output in V&P's after the LTM was significantly depressed to 40% of normal, but was normal in the STG groups. The delay in reaching normal values for trypsin and bile salt concentrations, was more marked in STG-BII owing to sequestration of secretions in the afferent loop. The low luminal concentrations of digestive secretions for the first 60 to 80 min after a LTM are therefore attributable to rapid gastric emptying in all operated groups, and in V&P to a depressed pancreatic enzyme response also. In STG-BII, afferent loop sequestration exaggerates the delay in attainment of normal intraluminal concentrations. The combined disturbance in STG-BII produces greater abnormalities than seen in STG-BI.
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Several concurrent phenomena contribute to the development of early dumping symptoms.
“Several concurrent phenomena contribute to the development of early dumping symptoms (3,(22)(23)(24)(25).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [23]
In the “V &P patients” section (page unavailable), the paper suggests that rapid gastric emptying may underlie dumping syndrome and reports post-meal diarrhea and symptomatic dumping. It does not establish that several concurrent phenomena contribute to early dumping symptoms; its discussion of multiple mechanisms concerns postoperative malabsorption, not dumping symptoms. (LLM, conf=0.78)
Experimental — accuracy not yet measuredThe pathophysiology of late dumping is largely attributable to the development of hyperinsulinemic or reactive hypoglycemia.
“In contrast to the multiple pathophysiologic factors involved in early dumping syndrome, the pathophysiology of late dumping is largely attributable to the development of hyperinsulinemic or reactive hypoglycemia (3,(22)(23)(24)(25).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [23]
The V&P patients section mentions dumping syndrome in connection with rapid gastric emptying, and the Discussion addresses gastric emptying and digestive secretions. Neither addresses late dumping or attributes it to hyperinsulinemic or reactive hypoglycemia (searched: late dumping, insulin, glucose, hypoglycemia). (LLM, conf=0.72)
Experimental — accuracy not yet measured
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Research works printed but not linked: 2
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Kunihara, M. L., & Meshi, T. (1981) · Journal of Pharmacobio-Dynamics · doi:10.1248/bpb1978.4.916 · Cited by 2
- Authors
- MacGregor, I., Parent, J., & Meyer, J. H.
- Affiliations
- San Francisco VA Medical Center (US)
- ORCID
- Meyer, J.H.
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 1977-02
- Volume
- 72
- Issue
- 2
- Pages
- 195-205
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W2211329744
- Cited by
- 163
- References
- 0
- Citations by year
- 2026: 1 · 2023: 3 · 2022: 1 · 2021: 4 · 2020: 1 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 2 · 2015: 3 · 2012: 2
- FWCI
- 21.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Keywords
- gastric emptying, pancreatic secretion, bile secretion, subtotal gastrectomy, truncal vagotomy, pyloroplasty, trypsin, bile salts, afferent loop
- MeSH terms
- Adult, Bile Acids and Salts, Bile Ducts, Cholecystokinin, Duodenum, Food, Gastrectomy, Gastrostomy, Humans, Jejunum, Male, Middle Aged, Pancreas, Polyethylene Glycols, Pylorus, Stomach, Trypsin, Vagotomy
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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