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Gastric Emptying of Liquid Meals and Pancreatic and Biliary Secretion After Subtotal Gastrectomy or Truncal Vagotomy and Pyloroplasty in Man
Open accessAbstract
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 (3,(22)(23)(24)(25).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [23]
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“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]
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Alcohol tolerance and gastric emptying after replacement of the oesophagus with the stomach.
Lam, K.-H., Wong, J., Lim, S. T., & Ong, G. (1980) · Australian and New Zealand Journal of Surgery · doi:10.1111/j.1445-2197.1980.tb04191.x · Cited by 5
Barthel, M., Nustede, R., Büchler, M., Köhler, H., & Schafmayer, A. (1988) · doi:10.1007/978-3-642-73472-4_13 · Cited by 5
Ehrlein, H., Thoma, G., Keinke, O., Tsiamitas, C., & Schumpelick, V. (1987) · Digestive Diseases and Sciences · doi:10.1007/bf01296038 · Cited by 4
“These findings suggest that a regulation of gastric emptying by inhibitory influences from the small intestine persisted after Roux-Y gastrectomy, It was only lacking after a fatty meal, probably due to a delayed or insufficient digestion of fat (26, 27).”
BackgroundPhysiology of the Exocrine Pancreas
Bernard, P. (1999) · Medical radiology · doi:10.1007/978-3-642-58380-3_2 · Cited by 6
Vergleich von Roux-Y-Rekonstruktion und jejunaler Interposition nach Gastrektomie
Schumpelick, V., Fass, J., & Bares, R. (1993) · doi:10.1007/978-3-642-78113-1_8 · Cited by 4
Malassimilationssyndrom (Maldigestion — Malabsorption)
Caspary, W. (1983) · doi:10.1007/978-3-642-68415-9_25 · Cited by 4
Sekundäre Pankreasinsuffizienz nach distaler Magenresektion
Büchler, M., Malfertheiner, P., Glasbrenner, B., & Beger, H. (2005) · Archiv fuer Klinische Chirurgie · doi:10.1007/bf01241944 · Cited by 3
Gastrointestinal motility and gastric emptying after Billroth II gastrectomy in dogs
Ehrlein, H., Wulschke, S., Thoma, G., & Schumpelick, V. (1989) · Digestive Diseases and Sciences · doi:10.1007/bf01537268 · Cited by 3
“These findings after Billroth II gastrectomy are consistent with previous observations in humans (16-18) and dogs (2, 7, 8).”
ResultLate complications of vagotomy in relation to alterations in physiology.
Passaro, E., & Stabile, B. (1978) · Postgraduate medicine · doi:10.1080/00325481.1978.11714812 · Cited by 3
Síndrome de malabsorción intestinal
García, S., Sicilia, B., & García, F. (2000) · doi:10.1016/s0304-5412(00)70032-1 · Cited by 3
Oral Pancreatic Function Tests in the Diagnosis and Staging of Chronic Pancreatitis
Rünzi, M., & Layer, P. (1997) · doi:10.1007/978-3-642-60580-2_30 · Cited by 3
The Assessment of Gastrointestinal Function
Labib, M., & Jones, B. (1994) · doi:10.1016/b978-0-7506-0167-2.50026-1 · Cited by 3
Ruppin, H. (1983) · Springer eBooks · doi:10.1007/978-3-642-68415-9_20 · Cited by 5
Nakada, K., Ikeda, M., Takahashi, M., Kinami, S., Yoshida, M., Uenosono, Y., Terashima, M., Oshio, A., & Kodera, Y. (2021) · World Journal of Gastrointestinal Surgery · doi:10.4240/wjgs.v13.i11.1484 · Cited by 2
Neurohormonal and Hormonal Control of Pancreatic Secretion
Owyang, C. (2018) · doi:10.1002/9781119188421.ch8 · Cited by 2
Gokgoz, S., Koyluoglu, G., Saraydın, S., Kaya, T., Gursoy, S., & Şen, M. (2004) · Surgery today (Print) · doi:10.1007/s00595-003-2658-4 · Cited by 2
Kunihara, M. L., & Meshi, T. (1981) · Journal of Pharmacobio-Dynamics · doi:10.1248/bpb1978.4.916 · Cited by 2
Metadata
- 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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