Abstracts
1998 Digestive Disease Week
#982
ILEAL ABSORPTIVE ADAPTATION TO JEJUNAL RESECTION AND EXTRINSIC DENERVATION: IMPLICATIONS FOR LIVING RELATED SMALL BOWEL TRANSPLANTATION. GG Tsiotos, K Bierens, J Duenes, MG Sarr. Dept. of Surg., Mayo Clinic, Rochester, MN.
Previously we showed decreased ileal absorption of water, electrolytes, bile salts, and glutamine after a canine model of jejunoileal autotransplantation (DDS 41:1915, 1996). AIM: To determine the role of extrinsic innervation in the ileal absorptive adaptation to jejunal resection. METHODS: 10 dogs were studied before, 2, and 12 wk after proximal 50% enterectomy without (CON, n=5) or with extrinsic denervation (EXT DEN, n=5) by a model of autotransplantation of the remaining ileum. Using a double-lumen perfusion technique, absorption of electrolytes and 5 simple nutrients (table) was measured at these 3 time points. RESULTS: All dogs developed diarrhea postop which resolved by 6 to 12 wk in all CON dogs but persisted in 2 of 5 EXT DEN dogs. Weight in both groups was decreased at 2 wk (p<0.05), remained low in EXT DEN (p<0.05), but normalized in CON dogs. Maximal weight loss was greater in EXT DEN (p<0.05). Intragroup analysis (paired t-tests) showed no consistent or important differences in absorption of electrolytes or simple nutrients among CON or in EXT DEN. Intergroup analysis at each time point showed no difference in absorption between groups.
|
|
|
|
|
|
|
|
|
CON
|
EXT DEN
|
|
|
Before
|
2 wk
|
12 wk
|
Before
|
2 wk
|
12 wk
|
|
|
33 ± 6
|
41 ± 7
|
42 ± 10
|
35 ± 3
|
34 ± 3
|
29 ± 3*
|
|
|
16 ± 8
|
29 ± 8
|
31 ± 8*
|
23 ± 4
|
23 ± 4
|
16 ± 3
|
|
|
37 ± 7
|
45 ± 8
|
46 ± 11
|
39 ± 3
|
40 ± 3
|
34 ± 3*
|
|
|
61 ± 6
|
67 ± 2
|
63 ± 7
|
64 ± 3
|
60 ± 4
|
54 ± 7
|
|
|
58 ± 5
|
67 ± 3
|
66 ± 5
|
67 ± 2
|
62 ± 5
|
68 ± 6
|
|
|
71 ± 3
|
70 ± 2
|
69 ± 9
|
71 ± 3
|
65 ± 4
|
61 ± 4
|
|
|
70 ± 5
|
63 ± 9
|
68 ± 8
|
64 ± 4
|
53 ± 9
|
50 ± 13
|
|
|
35 ± 11
|
39 ± 11
|
50 ± 10
|
47 ± 6
|
37 ± 6
|
35 ± 8
|
± SEM % absorption, n = 5/group; *differs from before, p < 0.05; no differences noted between groups at any time point.
SUMMARY: Extrinsic denervation of ileum results in persistent weight loss after proximal 50% enterectomy. Despite diarrhea, only minor changes in electrolyte absorption occur, and ileal absorption of simple nutrients remains unaffected. CONCLUSIONS: The extrinsic denervation necessitated by small bowel transplantation does not appear to influence the ileal absorptive adaptive response to jejunal resection.
Support NIH RO1 DK39337 [MGS].
Copyright 1996 - 1998, SSAT, Inc. Revised 29 June 1998.
|
