Ileal resection enhances jejunal absorptive adaptation for water and electrolytes to extrinsic denervation: implications for segmental small bowel transplantation.
OBJECTIVE
Segmental small bowel transplantation (SBT) may be an alternative to whole jejunoileal SBT. The aim of this study was to evaluate adaptability of extrinsically denervated jejunum after ileectomy.


METHODS
Baseline absorption of an isomolar, nonnutrient electrolyte solution was measured in an 80-cm in situ jejunal segment. Control (CON) and extrinsically denervated dogs (EXT DEN) then underwent distal 50% enterectomy; EXT DEN dogs also underwent a complete extrinsic denervation of remnant jejunum. Absorption was remeasured 2 and 12 weeks later; jejunal biopsies at 12 weeks were compared with baseline.


RESULTS
All dogs experienced weight loss and diarrhea, which resolved by 10 weeks in CON but persisted in EXT DEN dogs. Net absorptive fluxes of water, Na+, K+, and Cl-, however, remained unchanged in both groups 2 weeks and 12 weeks after denervation. Morphometric evaluation showed an increase in crypt depth in both groups at the 12-week time-point.


CONCLUSIONS
Despite a clinical short bowel syndrome, more weight loss, and diarrhea in EXT DEN, there were no temporal differences in net absorptive fluxes of water and electrolytes within or between these 2 groups, and both developed increased crypt depth at 12 weeks. Extrinsic denervation does not blunt jejunal adaptive response to ileectomy.
Libsch
Karen D
KD
Gastroenterology Research Unit and Department of Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Duininck
Troy M
TM
Sarr
Michael G
MG
D000222:Adaptation, Physiological; D000818:Animals; D003714:Denervation; D003967:Diarrhea / Q000209:etiology; D004285:Dogs; D004573:Electrolytes / Q000493:pharmacokinetics*; D005260:Female; D007082:Ileum / Q000601:surgery* / Q000637:transplantation; D007408:Intestinal Absorption; D007583:Jejunum / Q000294:innervation / Q000378:metabolism / Q000601:surgery* / Q000637:transplantation; D011183:Postoperative Complications; D012778:Short Bowel Syndrome / Q000378:metabolism*; D014867:Water / Q000378:metabolism*; D015431:Weight Loss
D004573:Electrolytes; D014867:Water