Stock-Damgé C, Aprahamian M, Raul F, Marescaux J, Scopinaro N
Scand J Gastroenterol. 1986 Nov;21(9):1115-23. doi: 10.3109/00365528608996431.
Morphologic and functional adaptations of the functioning intestine were evaluated in 41 patients before and after biliopancreatic bypass for morbid obesity. This surgical procedure diverts pancreatobiliary secretions via the duodenum and the jejunum into the colon, the remaining small intestine being anastomosed to the stomach after antrectomy. In the proximal ileum there was an 80% increase of the height of villi; the specific activities of maltase, sucrase, and aminopeptidase in brush border membranes remained unaffected, and that of lactase tended to decrease. In the distal ileum villi heights increased only by 58%, and disaccharidase activities (except for maltase) were slightly enhanced. In the colon the mucosa displayed, in some patients, focal appearance of true villi, and brush border enzyme activities increased concomitantly. We conclude that biliopancreatic bypass induces an adaptation of all intestinal segments of the functioning intestine; this adaptation tends to compensate for the shortening of the gut continuity.
对41例病态肥胖患者在胆胰转流术前后评估了功能性肠道的形态学和功能适应性。该手术通过十二指肠和空肠将胰胆分泌物转流入结肠，剩余小肠在胃窦切除术后与胃吻合。在近端回肠，绒毛高度增加了80%；刷状缘膜中麦芽糖酶、蔗糖酶和氨肽酶的比活性未受影响，乳糖酶的比活性有降低趋势。在远端回肠，绒毛高度仅增加58%，双糖酶活性（麦芽糖酶除外）略有增强。在结肠，部分患者的黏膜出现了真正绒毛的局灶性表现，同时刷状缘酶活性增加。我们得出结论，胆胰转流术可诱导功能性肠道所有肠段产生适应性变化；这种适应性变化倾向于补偿肠道连续性的缩短。
