Abstract
ObjectiveIleal transposition (IT) procedure leads to higher secretion of incretin hormones what is associated with a beneficial metabolic effect. However, IT will also have an influence on the related jejunum and ileum function. The aim of this research was to investigate the morphology of the jejunum and transposed ileum with the use of light and transmission electron microscopy (TEM) in order to determine the local alternations in the intestine resulting from the transposition.MethodsTwenty male, 8-week-old, obese Zucker rats underwent IT and six of them sham surgery. To compare both groups, the transection was made at all corresponding ileum positions among both groups of animals. The ileal anastomoses among the rats of sham procedure were subsequently formed accordingly without IT. Three months following the surgery, the tissue samples of jejunum and ileum were harvested.ResultsA significant increase in villus length, a decrease in the crypt depth, and an increased thickness of mucosa-muscularis-serosa (MMS) as well as cellular hyperplasia, with increased mitochondrial density of the transposed ileum segment, were observed among the group of rats which underwent IT comparing to the ones undergoing sham surgery. In rats undergoing IT, microvillus degeneration in jejunum regions was observed.ConclusionsIleal transposition alters the morphology and ultrastructure of the ileum as well as the jejunum. Given that the microvillus membrane represents an important aspect of the enterocyte functions, a further biochemical and molecular research is necessary in order to assess whether the observed changes are beneficial or not and to explore the phenomenon of gut adaptability after metabolic surgery.
Highlights
IntroductionThe current hypothesis of the diabetes remission after bariatric surgery is based on the so-called hindgut hypothesis where fast delivery of nutrients to the terminal ileum leads to a higher secretion of incretin hormones [1,2,3]
A significant increase in villus length, a decrease in the crypt depth, and an increased thickness of mucosamuscularis-serosa (MMS) as well as cellular hyperplasia, with increased mitochondrial density of the transposed ileum segment, were observed among the group of rats which underwent ileal transposition (IT) comparing to the ones undergoing sham surgery
Given that the microvillus membrane represents an important aspect of the enterocyte functions, a further biochemical and molecular research is necessary in order to assess whether the observed changes are beneficial or not and to explore the phenomenon of gut adaptability after metabolic surgery
Summary
The current hypothesis of the diabetes remission after bariatric surgery is based on the so-called hindgut hypothesis where fast delivery of nutrients to the terminal ileum leads to a higher secretion of incretin hormones [1,2,3] Based on this hypothesis, more attention was given to ileal transposition (IT). IT is a surgical procedure involving the transposition of a distal ileum segment to the proximal jejunum in a properistaltic direction with a continuity of the gastrointestinal tract This procedure results in a fast delivery of food to the terminal ileum followed by different metabolic alterations [4,5,6,7,8]. Several studies describe a higher secretion of these polipeptides due to increased glucose exposition after the ileal transposition followed by an early amelioration of glucose control and remission of type 2 diabetes [4, 5, 11, 12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
