Bonalumi U, Moresco L, Gianetta E, Civalleri D, De Cata T, Brignole E, Scopinaro N
Minerva Chir. 1980;35(13-14):993-6.
Transit times were evaluated in 23 obese subjects before and 1,4 and 12 months after biliopancreatic by-pass. A modified version of the method of Hinton et al. was used to determine emptying of the stomach and partial and total transit times. Emptying of the stomach was normal preoperatively. After surgery, it was almost immediate, except in two subjects with stomitis. Both transit times were virtually unchanged. Since the segment between the stomach and the ileocaecal valve is only half as long as in the normal subject, the results show that the by-pass leads to a slowing of transit that concerns the small intestine only, is quickly established, and does not change in the course of time. Evaluation of the altered anatomical and functional situation, and the absence of a correlation between the long-term behaviour of transit times on one hand and of lipid malabsorption and weight loss on the other-hand, suggest that a slower transit time must not be regarded as a compensation mechanism, except insofar as it restricts the degree of malabsorption set up immediately after surgery. Preliminary studies of enterohormonal changes following the by-pass indicate that increased glucagon and decreased motiline values are mainly responsible for slower transit times.
对23名肥胖受试者在胆胰转流术前以及术后1个月、4个月和12个月评估了转运时间。采用Hinton等人方法的改良版来测定胃排空时间以及部分和总转运时间。术前胃排空正常。术后，除了两名患有口腔炎的受试者外，几乎是立即排空。两个转运时间实际上都没有变化。由于胃和回盲瓣之间的肠段长度仅为正常受试者的一半，结果表明，转流导致仅涉及小肠的转运减慢，这种情况迅速出现，且不会随时间而改变。对改变后的解剖和功能状况的评估，以及一方面转运时间的长期变化与另一方面脂质吸收不良和体重减轻之间缺乏相关性，表明转运时间减慢不应被视为一种代偿机制，除非它限制了术后立即出现的吸收不良程度。对转流术后肠激素变化的初步研究表明，胰高血糖素增加和胃动素值降低是转运时间减慢的主要原因。
