WEIGHT loss has been frequently noted following total gastrectomy in man and the experimental animal.* This has been variously attributed to (1) inadequate intake of food secondary to the loss of the reservoir function of the stomach and (2) inadequate absorption of the ingested food. The latter factor has received much attention, being manifested as increased loss of fat and, at times, nitrogen in the feces. Frequently mentioned as possible etiologic factors are (1) increased speed of transit through the small intestine, (2) decreased secretion of bile and pancreatic juice secondary to disturbance or loss of the normal stimulating mechanisms, and (3) poor mixing of the ingested food and the digestive secretions.
In addition, there is evidence to suggest that bypassing of the duodenum as is commonly done after total gastrectomy may result in greater loss of fat and possibly nitrogen in the stool.†
These possibilities suggest that it might
KELLY WD, WANGENSTEEN OH. EXPERIMENTAL STUDIES ON TOTAL GASTRECTOMY: Influence of Type of Anastomosis and Creation of Artificial Stomach on Nutrition. AMA Arch Surg. 1954;69(5):616–622. doi:10.1001/archsurg.1954.01270050020006
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