Windsor C W, Fejfar J, Woodward D A
Gut. 1969 Oct;10(10):779-86. doi: 10.1136/gut.10.10.779.
This paper confirms that gastric hypersecretion can occur in man and dogs after massive intestinal resection. The assumption, made by others, that hypersecretion in the clinical situation is similar to that observed in dogs is challenged. An acute hypersecretory state occurred in eight of 19 patients after massive intestinal resection. This was apparent as an increased rate of basal secretion. It was usually transient and unrelated to the length of intestine resected. A correlation was noticed between hypersecretion and jaundice in the immediate postoperative period. Histamine release after acute hepatic injury was postulated as the cause of the hypersecretion. By contrast a chronic gastric hypersecretory state was demonstrated in dogs after massive intestinal resection. The rate of basal secretion was not significantly altered. The increased daily acid output was shown to be due to prolonged and enhanced response to food. The cause was thought to be loss of inhibitory agents, such as enterogastrone, normally released by the small intestine when in contact with food. The rationale of performing vagotomy and pyloroplasty at the same time as the intestinal resection is questioned.
本文证实，在人及犬进行大面积肠切除术后可出现胃酸分泌过多的情况。其他人所做的关于临床情况下胃酸分泌过多与犬类中观察到的情况相似的假设受到了质疑。19例患者中有8例在大面积肠切除术后出现急性胃酸分泌过多状态。这表现为基础分泌率增加。它通常是短暂的，与切除肠段的长度无关。术后即刻观察到胃酸分泌过多与黄疸之间存在相关性。推测急性肝损伤后组胺释放是胃酸分泌过多的原因。相比之下，犬在大面积肠切除术后出现慢性胃酸分泌过多状态。基础分泌率无显著改变。每日酸分泌量增加被证明是由于对食物的反应延长和增强所致。原因被认为是抑制性物质的丧失，如肠抑胃素，正常情况下小肠在接触食物时会释放这种物质。对在肠切除同时进行迷走神经切断术和幽门成形术的理论依据提出了质疑。
