2000 Abstract: 2319: Preservation of the Peptide YY-Activated Ileal Brake After Proctocolectomy and Jejunal Pouch-Distal Rectal Anastomosis.
Abstracts
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Reconstructing the enteric tract after proctocolectomy by interposing a jejunal pouch (JP) between the distal ileum and the distal rectum slows small intestinal transit and decreases the number of stools/day compared to a conventional ileal pouch (IP)-distal rectal reconstruction (Teixeira et al, J Gastro Surg, in press). Our hypothesis was that the JP operation brings about these results by protecting the ability of the ileal mucosa to secrete peptide YY (PYY), thus preserving the hormonal ileal brake on small intestinal transit and decreasing the stool frequency. In 5 JP dogs and 5 IP dogs > 5 mo postoperation, serum PYY concentrations were determined before and at 30 min intervals for 180 min after a 325 g canned dog chow meal. Basal serum concentrations of PYY, measured by radioimmunoassay, were greater in JP dogs (mean ± S.E.M., 1340 ± 143 pg/ml) than in IP dogs (804 ± 52 pg/ml, P < 0.01). Postprandial PYY concentrations in JP dogs were also greater at 30 min (JP = 1524 ± 131 pg/ml, IP = 913 ± 67 pg/ml, P = 0.01) and 60 min (JP = 1723 ± 250 pg/ml, IP = 1001 ± 70 pg/ml, P = 0.05) after the meal and peaked sooner (JP, 81 ± 17 min; IP, 147 ± 12 min; P = 0.01). We concluded that the JP operation preserves ileal basal and postprandial secretion of PYY better than the IP operation. The preservation may account, in part, for the slower small bowel transit and decreased number of stools after the JP operation. Support: Mayo Foundation and CAPES, Brasilia, Brazil. |
