Topics and Trends in Surgical Research: Postresection Hypergastrinemia Correlates with Malabsorption But Not Adaptation

Abstract

Massive intestinal resection is associated with transient hypergastrinemia and gastric hypersecretion. Gastric hypersecretion impairs intestinal absorption, but gastrin may be trophic during intestinal adaptation. Our aim was to determine if postresection hypergastrinemia correlates with malabsorption or adaptation. Ten dogs (13 to 19 kg) underwent 75% proximal intestinal resection. Intestinal remnant length and villus height was assessed at 12 weeks (n = 5) and 40 weeks (n = 5). Body weight and serum albumin, as well as stool fat, moisture, and weight, were measured preoperatively and at 4-week intervals for 40 weeks. Fasting serum gastrin values were measured by radioimmunoassay at similar intervals. Significant hypergastrinemia occurred between 4 and 28 weeks postresection. Hypergastrinemia did not correlate with increased intestinal remnant length (r= -.486, p =. 407) or villus height (r = -.410, p = 34). Duration of hypergastrinemia (>100 pg/ml) correlated with percentage of fecal fat at 12 weeks (r=. 807, p =. 015) and stool weight at 40 weeks (r=. 881. p =. 046). Thus, postresection hypergastrinemia correlates with early fat malabsorption and increased stool weight, but there is no correlation between hypergastrinemia and adaptation. These findings suggest that gastric hypersecretion, not hypergastrinemia, may be the more important pathophysiologic event afer intestinal resection.

Key Words:

• gastrin
• intestinal resection
• intestinal adaptation
• malabsorption