title: [Influence of digestive tract reconstruction techniques on plasma ghrelin level and body mass index after subtotal gastrectomy].
abstract: OBJECTIVE
  To study the impact of digestive tract reconstruction techniques on plasma ghrelin level and body mass index (BMI) after subtotal gastrectomy.
  
  
  METHODS
  Eighty-one patients undergoing subtotal gastrectomy for T1-3N0M0 gastric cancer were divided into three groups according to digestive tract reconstruction techniques, which included Billroth I group (n=30), Billroth II group (n=25) and Roux-en-Y group(n=26). Plasma ghrelin level was determined by radioimmunoassay preoperatively and one day, one week, half a year, and one year after gastrectomy. BMI was similarly recorded.
  
  
  RESULTS
  Plasma ghrelin levels of three groups decreased sharply to nadir one day after operation, which were (34.2±5.2)%, (37.7±4.7)% and (36.5±4.9)% respectively. A week after operation they were (52.6±6.5)%, (48.3±5.7)% and (48.1±6.0)%. There were no statistical difference between groups (P=0.075). Half a year postoperatively, they were (91.7±7.5)%, (80.4±8.1)% and (75.3±8.3)% and a year postoperatively(95.3±5.1)%, (84.5±6.3)% and (79.9±6.7)%, showing that Billroth I group was obviously higher than the other two groups (P<0.01) and Billroth II group was higher than Roux-en-Y group (P<0.05). BMI of three groups at a year after surgery descended by (2.1±1.1)%, (4.5±1.9)% and (5.7±1.8)% respectively, demonstrating statistical difference. Linear regression correlation existed in the three groups between decreasing amplitude of ghrelin and BMI (P<0.01).
  
  
  CONCLUSIONS
  Billroth I digestive tract reconstruction takes on the normal anatomy and physiology and therefore promotes compensatory ghrelin secretion. Falling of ghrelin level greatly contributes to the weight loss after subtotal gastrectomy.
authors.affiliation: Department of Gastroenterology, The Third Affiliated Hospital of Soochow University, Jiangsu Changzhou, China.
authors.forename: Hai-tao
authors.initials: HT
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Xu
authors.forename: Rong-chao
authors.initials: RC
authors.lastname: Wang
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhang
authors.forename: Qi-cheng
authors.initials: QC
authors.lastname: Lu
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005743:Gastrectomy; D005763:Gastroenterostomy / Q000379:methods*; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000097:blood / Q000601:surgery*
chemical_list: D054439:Ghrelin