Morphological and functional adaptation after massive resection of the small intestine: experiments using minipigs of the Göttingen strain.

In order to examine the adaptation processes in young, growing animals, massive resections of the small intestine were carried out in 3-week-old minipigs. The length of the remaining terminal intestine was 65 cm, corresponding to a resection of 85%. Proximal and distal resections of the small intestine were carried out. In some animals simultaneous resection of the ileocecal valve was performed. In some of the animals a reversed intestinal segment of 8 cm in length was interposed in the intestinal tract. The adaptation processes were checked at different times by morphological and functional examinations. It was observed that in animals with proximal intestinal resection and in animals with reversed intestinal segment, the postoperative progress was much more favorable than in animals with distal intestinal resection and animals without a reversed segment. It was further demonstrated that an early oral calorie supply is an important factor in the intestinal adaptation process. Contrary to views previously expressed, calories should be given early by mouth in order to stimulate the intestinal enzymes. After massive intestinal resection, the interposition of a reversed segment should also be considered in children if difficulties are expected with the oral supply of calories caused by a too-short terminal gut or if attempts at oral feeding have failed.