Analysis of fat digestive and absorptive function after subtotal gastrectomy by a 13C-labeled mixed triglyceride breath test.
OBJECTIVE
In the choice of reconstructions, digestive and absorptive disturbances, resulting in weight loss after subtotal gastrectomy, remain a problem. The aim of this study was to compare fat absorptive function after Billroth I (B-I) and Roux-en-Y (RY) reconstructions after subtotal gastrectomy for gastric cancer.


METHODS
A (13)C-labeled mixed triglyceride breath test was performed in 31 patients after subtotal gastrectomy and in 15 healthy volunteers to assess fat digestive and absorptive function. Seventeen B-I reconstructions and 14 RY reconstructions were performed after subtotal gastrectomy. Fat digestive and absorptive function was determined by percent (13)CO(2) cumulative dose at 7 h. Relationship between fat absorptive function and perioperative factors were analyzed.


RESULTS
Gender distribution, mean age, pathological staging, level of lymph node dissection, preservative procedure of the vagus nerve and mean follow-up period in the two surgical groups did not differ significantly. Only the type of reconstruction (p = 0.024) was associated with differences in fat digestive and absorptive function by univariate analysis: B-I reconstruction was superior to RY reconstruction.


CONCLUSIONS
Fat digestive and absorptive function after B-I reconstruction was superior to that after RY reconstruction, probably because the B-I reconstruction was the procedure that permitted food passage through the duodenum.
Nakamura
Hiroyuki
H
Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. hsurgeon1017@aioros.ocn.ne.jp
Murakami
Yoshiaki
Y
Morifuji
Masahiko
M
Uemura
Kenichiro
K
Hayashidani
Yasuo
Y
Sudo
Takeshi
T
Ohge
Hiroki
H
Sueda
Taijiro
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001944:Breath Tests; D002245:Carbon Dioxide / Q000378:metabolism; D002247:Carbon Isotopes; D015331:Cohort Studies; D004041:Dietary Fats / Q000378:metabolism*; D005260:Female; D005743:Gastrectomy; D015390:Gastric Bypass; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D014280:Triglycerides / Q000378:metabolism*
D002247:Carbon Isotopes; D004041:Dietary Fats; D014280:Triglycerides; D002245:Carbon Dioxide