Histologic studies of the bypassed stomach after Roux-en-Y gastric bypass in a porcine model.
BACKGROUND
Laparoscopic Roux-en-Y gastric bypass (LRYGBP) is highly effective for morbid obesity. However, the long-term effects in the bypassed segments are unknown. The aim of this study is to evaluate gastrin and histologic changes in bypassed segments after LRYGBP.


METHODS
10 50-kg pigs were subjected to LRYGBP. Preoperative weight and serum gastrin were compared with similar measures at 6 months postoperatively, when the pigs were euthanized. At necropsy, full-thickness gastric, duodenal, and jejunal biopsies were performed. Normal biopsies were obtained from a control group of 10 pigs.


RESULTS
1 pig died at 3 months postoperatively because of an intestinal intussusception. In the remaining 9 pigs, weight increased after surgery from 52+/-2.2 kg to 55+/-1.9 kg. Serum gastrin was unchanged after surgery (mean 68.2 vs 68.3 pg/mL at 3 months and 61.7 pg/mL at 6 months). Histology showed no abnormalities from sections in all control pigs, and in 7 of the LRYGBP pigs as well. 1 LRYGBP pig was found to have hyperplastic duodenal glands, jejunal mucosa with mild chronic inflammation, and gastric mucosa with focal erosive gastritis. 1 LRYGBP pig had jejunal sections showing Peyer's patches.


CONCLUSIONS
LRYGBP is not associated with gastrin changes and major histologic changes in the bypassed segments, at 6 months postoperatively in the porcine model.
Gentileschi
Paolo
P
Department of Surgery, New York Presbyterian Hospital, Weill College of Medicine of Cornell University, NY 10021, USA.
Gagner
Michel
M
Milone
Luca
L
Kini
Subhash
S
Fukuyama
Shoji
S
D000713:Anastomosis, Roux-en-Y / Q000379:methods; D000818:Animals; D004195:Disease Models, Animal; D015390:Gastric Bypass / Q000379:methods*; D005755:Gastrins / Q000097:blood; D011183:Postoperative Complications / Q000473:pathology; D013270:Stomach / Q000473:pathology* / Q000601:surgery; D013552:Swine
D005755:Gastrins