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[Intestinal malabsorption in patients treated with total gastrectomy]
A Csendes1, G Smok, P Burdiles
1Departamento de Cirugía y Anatomía Patológica, Hospital Clínico de la Universidad de Chile, Santiago.
Revista Medica De Chile
|December 1, 1993
Summary
Total gastrectomy often leads to weight loss and chronic diarrhea. Post-surgery fat malabsorption in patients is intraluminal, caused by uneven mixing of pancreatic and biliary secretions after Y-en-Roux reconstruction.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Digestive Physiology
Context:
- Total gastrectomy is a major surgery for gastric cancer or severe obesity.
- Patients frequently experience significant weight loss, chronic diarrhea, and fat malabsorption post-surgery.
- The Y-en-Roux reconstruction is a common surgical technique used after total gastrectomy.
Purpose:
- To investigate intestinal absorption parameters and jejunal mucosa histology in patients after total gastrectomy.
- To identify the underlying mechanisms of fat malabsorption in these patients.
- To correlate histological findings with clinical symptoms and laboratory data.
Summary:
- This study examined 26 patients at least one year post-total gastrectomy without tumor recurrence.
- Mean weight loss was 9 kg, with 46% experiencing diarrhea. Nutritional deficiencies (low hemoglobin, albumin, carotene, iron) were observed.
- Jejunal biopsies were normal, but steatocrit was universally abnormal, indicating fat malabsorption.
- Findings suggest intraluminal fat malabsorption results from impaired mixing of pancreatic and biliary secretions due to Y-en-Roux reconstruction.
Impact:
- Provides insight into the pathophysiology of malabsorption after total gastrectomy.
- Highlights the need for nutritional support and management strategies in post-gastrectomy patients.
- Suggests that malabsorption is primarily related to altered digestive secretions rather than mucosal damage.