Response of gastric inhibitory polypeptide (GIP) and insulin release after biliary reconstruction procedure or pancreaticoduodenectomy.

概要

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In order to investigate the effect of surgery in the biliary tract and pancreas upon the release of gastric inhibitory polypeptide (GIP) and insulin, a test-meal loading was performed on patients who underwent biliary tract reconstructions (jejunal interposition choledochoduodenostomy and Roux-Y choledochojunostomy) or pancreaticoduodenectomy.Although the fasting levels of plasma GIP were almost the same in both the interposition group and the Roux-Y group, the loading of the test-meal elicited a smaller response of GIP in the latter than in the former. The response of plasma insulin to the test-meal was scarcely altered in the interposition group, but was significantly diminished in the Roux-Y group, as compared with preoperative studies.In patients who undenwent pancreaticoduodenectomy, the fasting levels of plasma GIP and insulin were close to those in the control, not only before surgery but after surgery. After feeding, the preoperative levels of both GIP and insulin were similar to those of the control, while the levels of these hormones were markedly reduced after surgery.These results suggest that the release of GIP and insulin is mainly affected by the massive resection of the upper small intestine together with the head of the pancreas and the diversion of the stream of food or bile away from the proximal portion of the small intestine.
財団法人日本消化器病学会の論文