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001-es BibID:BIBFORM040222
Első szerző:Kalmár Katalin (orvos Pécs)
Cím:Postprandial Gastrointestinal Hormone Production Is Different, Depending on the Type of Reconstruction Following Total Gastrectomy / Katalin Kalmár, József Németh, Ágoston Kelemen, Örs Péter Horváth
Dátum:2006
ISSN:0003-4932
Megjegyzések:The present study examines the differences in gastrointestinalhormone production at 3 different reconstruction typesafter total gastrectomy.Background Data: Total gastrectomy causes significant weightloss, mainly due to a reduced caloric intake probably because of alack of initiative to eat or early satiety during meals. Behind thisphenomenon a disturbed gastrointestinal hormone production can bepresumed.Methods: Patients participating in a randomized study were recruitedfor the clinical experiment. Seven patients with simpleRoux-en-Y reconstruction, 11 with aboral pouch (AP) construction,and 10 with aboral pouch with preserved duodenal passage (APwPDP)reconstruction, as well as 6 healthy volunteers were examined.Blood samples were taken 5 minutes before and 15, 30, and 60minutes after ingestion of a liquid test meal. Plasma concentrationsfor insulin, cholecystokinin, and somatostatin were determined byradioimmunoassay analysis.Results: Postprandial hyperglycemia was observed in patients aftertotal gastrectomy most prominently in groups with duodenal exclusion(Roux-en-Y and AP) compared with healthy controls. Postprandialinsulin curves reached significantly higher levels in all operatedgroups compared with controls, however, with no difference accordingto reconstruction type. Significantly higher cholecystokininlevels and higher integrated production of cholecystokinin wereobserved in Roux-en-Y and AP groups compared with APwPDP andcontrol. Postprandial somatostatin levels were significantly differentbetween the 4 groups, and highest levels and integrated secretionswere reached in AP group, lowest in APwPDP and normal groups.Conclusion: A disturbed glucose homeostasis was observed ingastrectomized patients most prominently in the Roux-en-Y group.Also, cholecystokinin and somatostatin response differed significantlyin favor of duodenal passage preservation after total gastrectomy.Cholecystokinin levels close to physiologic found at APwPDPreconstruction may contribute to a physiologic satiation in reconstructionswith preserved duodenal passage after total gastrectomy.
Tárgyszavak:Orvostudományok Elméleti orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Annals Of Surgery. - 243 : 4 (2006), p. 465-471. -
További szerzők:Németh József (1954-) (vegyész, analitikus) Kelemen Ágoston Horváth Örs Péter (sebész)
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