Effect of duodenal switch procedure on gastric acid production, intragastric pH, gastric emptying, and gastrointestinal hormones.
The duodenal switch operation preserves the pylorus and the proximal 3 to 7 cm of duodenum in continuity with the stomach while diverting pancreaticobiliary secretions. We compared it with the Roux-en-Y without vagotomy or antrectomy in 12 dogs with innervated gastric pouches. Acid secretion was inhibited between tests using ranitidine in the Roux-en-Y group only, but two of the six dogs still developed stomal ulcers and the remainder showed stomal hyperemia. This may be due to a significant increase in gastric acid output after Roux-en-Y, but gastric emptying and plasma gastrin, cholecystokinin, secretin, gastric inhibitory polypeptide, peptide YY, and neurotensin were similar after both procedures. In 12 patients and a further 6 dogs, the duodenal switch caused no significant change in the intragastric pH environment as assessed by intragastric pH monitoring. The duodenal switch is a suitable procedure for pancreaticobiliary diversion.
Welch
N T
NT
Department of Surgery, Creighton University School of Medicine, Omaha, Nebraska 68131.
Yasui
A
A
Kim
C B
CB
Barlow
A P
AP
Hinder
R A
RA
DeMeester
T R
TR
Polishuk
P V
PV
Clark
G W
GW
Adrian
T E
TE
D000713:Anastomosis, Roux-en-Y; D000818:Animals; D004285:Dogs; D004383:Duodenogastric Reflux / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005744:Gastric Acid / Q000378:metabolism; D005745:Gastric Acidity Determination; D005746:Gastric Emptying / Q000502:physiology; D005768:Gastrointestinal Hormones / Q000378:metabolism; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged
D005768:Gastrointestinal Hormones