[Postprandial plasma secretin response in various types of reconstructive surgery of the stomach and pancreas].

The postprandial plasma secretin concentrations were investigated in patients with Billroth I, Billroth II, Roux-en Y and jejunal interposition following gastrectomy or modified Child's reconstruction after pancreatoduodenectomy. In patients with Billroth I anastomosis the postprandial plasma secretin response was not so high as that for normal volunteers, however it was much better compared with Billroth II anastomosis and Roux-en Y anastomosis after total gastrectomy. In an interposed jejunal anastomosis after total gastrectomy the plasma secretin increased at 20 minutes in postprandial state, even though there was not clear postprandial response of plasma secretin in patients with Roux-en Y anastomosis. Following the modified Child's method after pancreatoduodenectomy the postprandial plasma secretin response was similar to that of Billroth II anastomosis. Following acid load plasma secretin response was much higher than that of postprandial state in patients with Billroth-I, Billroth-II and Roux-Y anastomosis after gastrectomy. The results indicate that acid is important in stimulating secretin release and also the passage of food through the duodenum is important for the release of secretin.