Armbrecht U, Lundell L, Stockbruegger R W
Digestion. 1987;37 Suppl 1:56-60. doi: 10.1159/000199542.
Malnutrition is common after total gastrectomy. Different pathophysiological reasons have been reported. We have investigated malabsorption in patients after total gastrectomy and Roux-Y esophagojejunostomy, analyzing the orocecal transit time, the bacterial flora of the upper intestine, and the small intestinal carbohydrate fermentation. Furthermore, we studied the benefit of pancreatic enzymes in this condition. The orocecal transit time was found to be short in 5/11 patients. In 4/11 patients upper intestinal bacterial overgrowth was probable. In the remaining 3/11 patients with steatorrhea, pancreatic dysfunction, due to understimulation, was suspected to be the reason for malassimilation. A subsequent double-blind, cross-over trial on supplementary treatment with pancreatic enzymes was performed in 15 patients. This treatment did not significantly reduce the degree of steatorrhea in these patients.
全胃切除术后营养不良很常见。已有不同的病理生理原因报道。我们对全胃切除和Roux-Y食管空肠吻合术后患者的吸收不良情况进行了研究，分析了口盲肠转运时间、上段肠道菌群及小肠碳水化合物发酵情况。此外，我们研究了胰酶在这种情况下的作用。发现11例患者中有5例口盲肠转运时间短。11例患者中有4例可能存在上段肠道细菌过度生长。其余3例有脂肪泻的患者，因刺激不足导致的胰腺功能障碍被怀疑是吸收不良的原因。随后对15例患者进行了胰酶补充治疗的双盲交叉试验。该治疗并未显著降低这些患者的脂肪泻程度。
