Effect of massive bowel resection on enteroinsular axis.

Pancreatic endocrine function was studied in 13 patients who had undergone massive bowel resection. The patients were divided into two groups: one month after operation (short-term group), and three or more months after operation (long-term group). Oral administration of glucose caused a persistent low insulin secretion in almost all the patients and the glucose tolerance curve showed a diabetic pattern in four. In contrast, the insulin response to intravenously infused arginine was impaired in the short-term group, but was at an approximately normal level in the long-term group. Pancreatic glucagon response to intravenous arginine, however, remained unchanged in both groups. Interruption of the enteroinsular axis as the result of massive bowel resection probably plays a major part in this discrepancy of the behaviour of insulin in the long-term group.