[Gut hormone profiles after various types of gastrointestinal surgery]

Gastrointestinal and pancreatic hormone responses to test meal or oral glucose were studied in totally gastrectomized patients (TG), subtotally gastrectomized patients with BI and BII, patients with pylorus preserving gastrectomy (PPG), a case of massive (4m 15 cm) bowel resection (MBR) and patients with pancreatoduodenectomy (PD), and compared to the pattern of healthy control subjects (HC). Plasma IRI, GIP and GLI responses to meal in TG and BII were significantly higher, and those in BI appeared to be higher than those in HC. In contrast, those hormonal patterns in PPG were similar to HC. Thus, it seemed that PPG was more physiological than any other gastrectomies in the viewpoints of GI hormonal patterns. In a case of MBR, plasma GLI response to oral glucose, expressed as peak/basal GLI, was significantly higher compared to HC. This higher GLI responsiveness together with remarkably high plasma gastrin level in this case might have a role in stimulating the adaptative changes found after MBR. IRI and GIP responses to oral glucose were impaired following PD without pancreatojejunostomy, while after operating pancreatojejunostomy, those responses restored in part which might suggest the significant role of the pancreatic juice into the jejunum in releasing mechanism of these hormones.