Gianetta E, Bloom S R, Sarson D L, Civalleri D, Bonalumi U, Friedman D, Adami G F, Pitton L, Brignole E, Traverso E, Scopinaro N
Boll Soc Ital Biol Sper. 1980 Oct 15;56(19):1922-8.
Biliopancreatic bypass for obesity entails a 2/3 distal gastrectomy with Roux-en-Y reconstruction, being the small bowel transected at its midpoint and the enteroenteroanastomosis placed 50 cm proximal to the ileocecal valve. Insulin and GIP fasting and meal-stimulated plasma concentrations were determined in 13 nonobese healthy volunteers, in 13 nonoperated obese patients, in 11 subjects within two months, in 12 subjects four to twelve months, and in 7 subjects fifteen to twenty months after operation. Insulin in the obese patients was significantly higher than in the control group. Postoperatively these patients showed a sharp reduction in basal and postprandial values. Plasma insulin levels, both basally and following the test meal, were very similar in the 15-20 month and the control group. Plasma GIP fasting level, meal-stimulated peak and integrated response in the obese group were higher than in control group. Due to the extreme variability among subjects in the obese group, the difference was significant only for the mean peak response. All values were greatly reduced after surgery. The mean fasting level in the 15-20 month group was very similar to that in the control group, and both peak and integrated responses were significantly lower than in the preoperative and control groups.
用于治疗肥胖症的胆胰转流术包括进行三分之二的远端胃切除术并采用Roux-en-Y重建，即小肠在其中点处横断，肠肠吻合术位于回盲瓣近端50厘米处。对13名非肥胖健康志愿者、13名未接受手术的肥胖患者、11名术后两个月内的受试者、12名术后四至十二个月的受试者以及7名术后十五至二十个月的受试者测定了胰岛素和GIP空腹及餐后刺激后的血浆浓度。肥胖患者的胰岛素水平显著高于对照组。术后这些患者的基础值和餐后值急剧下降。术后15至20个月组的血浆胰岛素基础水平和试验餐后水平与对照组非常相似。肥胖组的血浆GIP空腹水平、餐后刺激峰值和综合反应均高于对照组。由于肥胖组受试者之间差异极大，仅平均峰值反应的差异具有显著性。术后所有值均大幅降低。术后15至20个月组的平均空腹水平与对照组非常相似，峰值和综合反应均显著低于术前组和对照组。
