Bittner R, Bittner B, Beger H G
Z Gastroenterol. 1981 Nov;19(11):698-707.
In 45 patients there was performed an oral glucose tolerance test after different types of gastric resection (Billroth I, Billroth II, total gastrectomy with a reconstitution with preservation of the food passage through the duodenum, total gastrectomy with exclusion of the duodenum). Additionally some patients with the same type of resection but with different types of stomach disease were investigated. The following results were achieved: 1. An increasingly reduction of the gastric remnant - 60% resection (B I), 75% resection (B II), total gastrectomy - leads after an oral glucose load to increasingly more rapid rise of blood glucose as well as to increasingly higher peak values of blood glucose concentration. 2. In patients with preserved food passage through the duodenum the oral glucose tolerance is significantly better and the secretory capacity of the beta-cells is significantly higher. 3. In spite of the same type of gastric resection patients with different types of stomach disease have as well as different patterns of oral glucose tolerance curve. Patients with Billroth II - gastric resection because of duodenal ulcer have significant more frequently a late postprandial hypoglycemia (without preceding hyperglycemia) than the patients with Billroth II because of ulcer/neoplasma ventriculi.
对45例患者在进行不同类型的胃切除术后（毕罗一式、毕罗二式、保留十二指肠通道重建的全胃切除术、不保留十二指肠的全胃切除术）进行了口服葡萄糖耐量试验。此外，还对一些切除类型相同但患有不同类型胃部疾病的患者进行了研究。得到了以下结果：1. 胃残余量逐渐减少——切除60%（毕罗一式）、切除75%（毕罗二式）、全胃切除——口服葡萄糖负荷后导致血糖上升越来越快，以及血糖浓度峰值越来越高。2. 在保留十二指肠通道的患者中，口服葡萄糖耐量明显更好，β细胞的分泌能力明显更高。3. 尽管胃切除类型相同，但患有不同类型胃部疾病的患者也有不同的口服葡萄糖耐量曲线模式。因十二指肠溃疡接受毕罗二式胃切除术的患者比因胃溃疡/胃肿瘤接受毕罗二式胃切除术的患者更频繁地出现明显的餐后晚期低血糖（无先前的高血糖）。
