Faecal fat excretion after truncal, selective, and highly selective vagotomy for duodenal ulcer

Abstract

SUmmARY Faecal fat excretion was measured on a metabolic ward in 16 patients with duodenal ulcer before operation, and in patients who were in good health more than one year after truncal vagotomy and pyloroplasty (n = 11), bilateral selective vagotomy and pyloroplasty (n = 9), or highly selective vagotomy without a drainage procedure (HSV, n = 12). Excretion of faecal fat was significantly greater (P < 0.01) in patients after both truncal and selective vagotomy with drainage than in patients before operation. Fat excretion in HSV patients was little different from that of preoperative patients.If steatorrhoea is defined as a faecal fat output of more than 6 g per day, one of 16 preoperative patients with duodenal ulcer (6%) had steatorrhoea, one of 12 HSV patients (8 %) had steatorrhoea, one of nine patients after selective vagotomy and pyloroplasty (11 %) had steatorrhoea but five of 11 patients after truncal vagotomy and pyloroplasty (45%) had steatorrhoea.'Two hundred and fifty-five patients were investigated more than fifteen years after vagotomy and gastroenterostomy. Weight loss of more than 6 kg was observed in 32-5 % of men and 60 % of women. Haemoglobin levels below 90% were found in 43.5% of men, and below 80% in 84% of

Estimation of14C-Triolein Assimilation as a Test of Lipid Assimilation

“…From studies of groups of patients we know that increased faecal fat excretion may occur in various gastrointestinal diseases (12)(13)(14) and that faecal fat excretion reflects the severity of the disease (14). An exact estimation of lipid assimilation may be difficult.…”

“…This group consisted of patients with a) diseases compatible with malassimilation (12)(13)(14) but in whom faecal fat was within normal limits (no. Patients with probable abnormalities in lipid assimilation (no.…”

Effect of Truncal Vagotomy on GIP Release Induced by Intraduodenal Glucose or Fat in Dogs

“…First, we must consider the absorptive function because the absorption of nutrients from the intestine is necessary for GIP re lease [18]. Some investigators have suggested that TV with pyloroplasty reduces fat absorp tion [19,20]. There is a possibility, therefore, that the apparent GIP response to fat did not change after TV, even though TV might di rectly increase the reactivity of the GIP cells to fat as well as to glucose.…”

Postoperative gastrointestinal physiology following operations on the stomach

“…Many patients lose weight after gastric surgery; as a consequence malnutrition and specific nutritional deficiencies may develop. Mild steatorrhea is common after gastric surgery (table 1), but daily fecal fat output seldom exceeds 15% of fat intake [17,18]. Different factors may contribute to this effect: (1) impaired pancreatic and biliary secretory responses; (2) normal pancreaticobiliary secretions, but a changed, unfavorable ratio between food and digestive juices; (3) accelerated transit of chyme through the small intestine leading to insufficient time available for digestion; as a consequence undigested food reaches the colon; (4) after distal gastrectomy, pieces of food larger than 1 mm empty from the stomach into the Degen/Beglinger small intestine.…”