The role of humoral factors and the ileocecal valve in pathological changes occurring after distal small bowel resection.

Abstract

Experimental studies using dogs were performed to elucidate the participation of gastrointestinal hormones as well as the ileocecal valve in postoperative sequelae following massive small bowel resection. Although in both the ileal resection and the ileocecal resection groups the absorption of fat was reduced postoperatively, body weight tended to increase in the former, while it decreased gradually in the latter. In addition, watery diarrhea persisted after ileocecal resection. Plasma total bile acid concentrations in each group were lower than those before surgery, as were plasma levels of both total glucagon and neurotensin. Although differences were not significant, plasma neurotensin levels tended to be higher after ileocecal resection, but plasma total glucagon levels tended to be lower. Plasma gastric inhibitory polypeptide (GIP) response to butter ingestion was also lower after both ileal and ileocecal resection; especially in the latter case the decrease was significant. These results indicate that the diminished plasma levels of neurotensin, enteroglucagon and GIP may be related to the impairment of adaptive changes in the remaining small intestine.