[Bone changes in patients after partial gastric resection]

Metabolic diseases of the bones may be a serious complication of gastrectomy. The pathogenesis of osseous changes is multifactorial. The most important causes include a reduced intake of dairy products, their fastened passage through the stomach and reduced calcium and vitamin D absorption. The objective of the work was to assess bone changes in patients after partial gastrectomy. From a total number of 261 patients with a minimal 10-year history of gastrectomy, in the investigation 31 patients were included (18 men and 13 women) who met the required criteria. The results were compared with a control group of 18 men and 13 women of equal age. The authors compared also groups of patients with the condition after surgery type Billroth I (8 patients) and Billroth II (23 patients). In all investigated subjects the authors examined the bone density in the area of the lumbar spine and neck of the femur and parameters of osteoresorption and osteoformation. The authors found a significant reduction of bone density in the area of the spine and neck of the femur (p < 0.001) and a significantly higher level of total alkaline phosphatase and intact parathormone in serum and N-terminal telopeptide collagen type I in urine (p < 0.001), as compared with the control group. The other parameters did not differ in the investigated groups. The authors did not find a statistically significant difference in the investigated parameters between patients after resection Billroth I and Billroth II. The results confirm the need of early diagnosis and treatment of bone changes in patients after partial gastrectomy.