胃癌患者における胃切除術後の薬物吸収動態

Abstract

We investigated the absorption rates of acetaminophen, theophyline and lansoprazole after pylorus preserving-gastrectomy (PPG) with preservation of the vagal nerve as a treatment for patients with early gastric cancer. Postoperative functioning of the residual stomach 6 months after the operation in patients with early gastric cancer who had undergone PPG (PPG group, n=5) was compared with that in patients who had undergone distal gastrectomy (DG group, n=4). We also investigated recovery of body weight, findings in a series of gastrointestinal X-rays, gastroscopic findings, hormonal secretion and digestive and absorbtive abilities.The postoperative absorption rates of acetaminophen in the PPG group were almost the same as those before the operation, but they were slower in the PPG group than in the DG group.The absorption rate of theophyline from a sustained release formulation was faster in the DG group, and slower in the PPG group compared to the preoperative absorption rates. In the DG group, the absorption rate of an enteric-coated preparation of lansoprazole did not differ greatly from that before the operation. In the PPG group, however, there were large individual differences and a notable delay in absorption and reduction in the amount of absorption in the early stage.Recovery of body weight at 6 months after the operation was not significantly different in the PPG and DG groups. In the PPG group, postoperative gastrointestinal X-rays showed that the pyloric form had been retained, and gastroscopic examination showed that there had been no reflux gastritis or esophagitis. The rates of digestion and absorption were faster in the DG group than in the PPG group, and the plasma levels of glucose were higher but the serum levels of gastrin were lower in the DG group than in the PPG group.Furthermore, hormonal secretion in the PPG group was close to the normal physiological range.These results indicate that the rate of absorption was faster in the DG group and slower in the PPG group.The absorbability of drugs following gastric resection varies depending on the type of operation and the properties of the drug preparation.