title: Effect of duodenal switch procedure on gastric acid production, intragastric pH, gastric emptying, and gastrointestinal hormones.
abstract: 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.
authors.affiliation: Department of Surgery, Creighton University School of Medicine, Omaha, Nebraska 68131.
authors.forename: N T
authors.initials: NT
authors.lastname: Welch
authors.forename: A
authors.initials: A
authors.lastname: Yasui
authors.forename: C B
authors.initials: CB
authors.lastname: Kim
authors.forename: A P
authors.initials: AP
authors.lastname: Barlow
authors.forename: R A
authors.initials: RA
authors.lastname: Hinder
authors.forename: T R
authors.initials: TR
authors.lastname: DeMeester
authors.forename: P V
authors.initials: PV
authors.lastname: Polishuk
authors.forename: G W
authors.initials: GW
authors.lastname: Clark
authors.forename: T E
authors.initials: TE
authors.lastname: Adrian
mesh_terms: 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
chemical_list: D005768:Gastrointestinal Hormones