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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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Research works printed but not linked: 34
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Meyer, J. H. (1979) · Digestive Diseases and Sciences · doi:10.1007/bf01324735
“hitherto unappreciated interrelations between the time course of gastric emptying and the time courses of biliary or pancratic secretion (9); have shown a 60% reduction in pancreatic response to a meal stimulus after t runcal vagotomy (8) (confirming more precise experiments in animals); and have shown us that less th…”
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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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