The changes in gastric acid secretion and gastrointestinal hormone release were studied after biliary tract reconstruction to investigate the mechanism of gastric acid hypersecretion after a biliary diversion procedure. At follow-up, gastric acid output in patients with Roux-Y choledochojejunostomy was significantly higher than before the operation. In contrast, in patients with jejunal interposition choledochoduodenostomy, which does not bring about biliary diversion, acid output increased slightly after the operation. Moreover, at follow-up, acid output in the Roux-Y group was slightly higher than it was in the interposition group. Although the fasting levels of plasma gastric inhibitory polypeptide were almost the same in both groups, the loading of a test meal elicited a lower response of plasma gastric inhibitory polypeptide in patients with the Roux-Y procedure than in those with the interposition procedure. Therefore, it is assumed that gastric inhibitory polypeptide, as an enterogastrone after a biliary reconstruction procedure, might have some influence on gastric acid secretion.
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