The Clinical and Metabolic Consequences of Total Gastrectomy

Abstract

Some aspects of the metabolism of fat, protein, carbohydrate, minerals, and vitamins, and the changes in intestinal histology and radiology found in a series of twenty patients surviving total gastrectomy are reported and the literature reviewed briefly.

The presence or degree of steatorrhoea was not related to any of the clinical or metabolic sequelae of the operation. Upsets of serum proteins were found in three cases, being ascribed to deficient intake of protein in one case. Glucose absorption tests were usually abnormal and defects were often multiple. Xylose malabsorption was found in four cases. Haemostatic defects were detected in three cases and were shown to be due to vitamin K deficiency in two; the defect was mild and self-correcting. Two cases of metabolic bone disease were found; the disease appeared to be slowly progressive. Vitamin A deficiency was found in five patients and iodine deficiency in eight. The evidence suggests that the various defects did not result solely, if at all, from malabsorption. Changes in intestinal histology were usually minor and, like the radiological changes, were not related to deficiency states or malabsorption.

Key-words:

• Stomach
• metabolism
• gastrectomy