TY - JOUR
T1 - Role of extrinsic innervation in jejunal absorptive adaptation to subtotal small bowel resection
T2 - A model of segmental small bowel transplantation
AU - Libsch, Karen D.
AU - Zyromski, Nicholas J.
AU - Tanaka, Toshiyuki
AU - Kendrick, Michael L.
AU - Haidenberg, Jaime
AU - Peia, Daniela
AU - Worni, Matthias
AU - Duenes, Judith A.
AU - Kost, Louis J.
AU - Sarr, Michael G.
N1 - Funding Information:
Supported in part by a grant from the National Institutes of Health (NIH RO1 39337 to M.G.S.) and the Department of Surgery, Mayo Clinic.
PY - 2002
Y1 - 2002
N2 - Segmental small bowel transplantation offers theoretic advantages over total jejunoileal transplantation, but the regional ability of the transplanted segment to adapt is unknown. Absorption was measured in an 80 cm jejunal segment via a triple-lumen perfusion technique. Separate experiments measuring absorption of four nutrients (glucose, glutamine, oleic acid, and taurocholic acid) were performed before and 2 and 12 weeks after operative intervention. Control dogs (CON, n = 6) underwent distal 50% enterectomy. Experimental dogs (EXT DEN, n = 6), in addition to resection, underwent complete extrinsic denervation of the remaining jejunum. All dogs developed diarrhea, which rhesolved in all CON dogs but persisted in all EXT DEN dogs. Maximal weight loss was greater in the EXT DEN group. Glucose and oleate absorption was decreased 2 weeks after ileal resection in both the CON and EXT DEN dogs; glutamine absorption was decreased at 2 weeks in EXT DEN dogs only. Taurocholate and water absorption remained unchanged in both groups. Absorption of all solutes returned to baseline at 12 weeks in both groups. Despite greater weight loss and persistent diarrhea in EXT DEN dogs, at 12 weeks there were no differences in net absorptive fluxes between the EXT DEN and the CON group after extrinsic denervation. The extrinsic denervation necessitated by small bowel transplantation does not appear to blunt the net jejunal adaptive response to total ileal resection, but may temporarily alter glutamine absorption.
AB - Segmental small bowel transplantation offers theoretic advantages over total jejunoileal transplantation, but the regional ability of the transplanted segment to adapt is unknown. Absorption was measured in an 80 cm jejunal segment via a triple-lumen perfusion technique. Separate experiments measuring absorption of four nutrients (glucose, glutamine, oleic acid, and taurocholic acid) were performed before and 2 and 12 weeks after operative intervention. Control dogs (CON, n = 6) underwent distal 50% enterectomy. Experimental dogs (EXT DEN, n = 6), in addition to resection, underwent complete extrinsic denervation of the remaining jejunum. All dogs developed diarrhea, which rhesolved in all CON dogs but persisted in all EXT DEN dogs. Maximal weight loss was greater in the EXT DEN group. Glucose and oleate absorption was decreased 2 weeks after ileal resection in both the CON and EXT DEN dogs; glutamine absorption was decreased at 2 weeks in EXT DEN dogs only. Taurocholate and water absorption remained unchanged in both groups. Absorption of all solutes returned to baseline at 12 weeks in both groups. Despite greater weight loss and persistent diarrhea in EXT DEN dogs, at 12 weeks there were no differences in net absorptive fluxes between the EXT DEN and the CON group after extrinsic denervation. The extrinsic denervation necessitated by small bowel transplantation does not appear to blunt the net jejunal adaptive response to total ileal resection, but may temporarily alter glutamine absorption.
KW - Bile acid absorption
KW - Extrinsic denervation
KW - Fat absorption
KW - Glucose absorption
KW - Glutamine absorption
KW - Intestinal adaptation
KW - Small bowel transplantation
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U2 - 10.1016/S1091-255X(01)00074-9
DO - 10.1016/S1091-255X(01)00074-9
M3 - Article
C2 - 11992810
AN - SCOPUS:15944381926
SN - 1091-255X
VL - 6
SP - 240
EP - 247
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 2
ER -