Comparing reconstruction with ileocecal graft to jejunal interposition pouch after total gastrectomy in rats.
After total gastrectomy, the ileocecal graft may act as a reservoir and protect against reflux but give rise to transposition of the ileum and cause possible changes in bile acid metabolism and nutrition. This study compared the ileocecal graft and jejunal pouch. Male Wistar rats weighing 265 +/- 22 g were submitted to sham operation (S), ileocecal interposition graft (IIG), and jejunal pouch interposition graft (JP) after total gastrectomy. Eight weeks later, the esophagus was examined for evidence of esophagitis. Nutritional biochemistry and weight profile were documented preoperatively and 8 weeks after surgery. The oral glucose tolerance test was performed. Thirty-three rats were operated on and 30 survived for 8 weeks. Esophagitis occurred in seven JP rats. Body weight was significantly higher in IIG than in JP rats (p < .05). Normal glucose tolerance to intragastric glucose load was observed in sham and operated rats. JP rats had a significant decrease in serum albumin, glucose, transferrin, hemoglobin, iron, folate, and calcium, compared to sham (p < .05). Cobalamine was significantly lower in IIG rats than in JP rats (p < .05). In the IIG and JP groups, serum/hepatic total bile acid did not differ significantly from preoperative and sham values. In conclusion, the IIG interposition graft in rats prevented esophagitis, preserved nutrition, and did not interfere with enterohepatic total bile acid circulation.
Medeiros
Aldo Cunha
AC
Federal University of Rio Grande do Norte (UFRN), Postgraduate Program in Health Sciences, Natal, Brazil. aldo@ufrnet.br
Filho
Irami Araújo
IA
Medeiros
Vítor Brasil
VB
Pinheiro
Laíza Araújo Mohana
LA
Freire
Flávio Henrique Miranda Araújo
FH
Azevedo
Italo Medeiros
IM
Brandão-Neto
José
J
D000714:Anastomosis, Surgical; D000818:Animals; D001647:Bile Acids and Salts / Q000378:metabolism; D001835:Body Weight; D002118:Calcium / Q000097:blood; D004386:Duodenum / Q000601:surgery; D004764:Enterohepatic Circulation; D004942:Esophagitis, Peptic / Q000517:prevention & control; D004947:Esophagus / Q000601:surgery; D005492:Folic Acid / Q000097:blood; D005743:Gastrectomy / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000517:prevention & control; D005951:Glucose Tolerance Test; D006454:Hemoglobins / Q000032:analysis; D006996:Hypocalcemia / Q000209:etiology; D007080:Ileocecal Valve / Q000637:transplantation*; D007408:Intestinal Absorption; D007583:Jejunum / Q000637:transplantation*; D008055:Lipids / Q000097:blood; D008297:Male; D011178:Postgastrectomy Syndromes / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control; D051381:Rats; D017208:Rats, Wistar; D014168:Transferrin / Q000032:analysis; D016042:Transplantation, Heterotopic; D014805:Vitamin B 12 / Q000097:blood
D001647:Bile Acids and Salts; D006454:Hemoglobins; D008055:Lipids; D014168:Transferrin; D005492:Folic Acid; D014805:Vitamin B 12; D002118:Calcium