Surgical aspect of enteroinsular axis after gastrointestinal surgery with reference to incretin secretion

Hiroo Naito, Iwao Sasaki, Seiki Matsuno

Research output: Contribution to journalReview article

7 Citations (Scopus)

Abstract

An alteration of the enteroinsular axis (EIA) may be an important etiologic factor in postsurgical changes in gastrointestinal (GI) function. In this review, we present recent works, both from our laboratory and others, on how changes in the EIA function may be involved in postsurgical GI complications, especially late dumping syndrome (LDS). We found no or minimal direct role for vagal signals in the control of gastric inhibitory polypeptide (GIP) and enteroglucagon secretion, which regulate EIA function. In gastrectomized patients, it is suggested that the hypersecretion of glicentin and glucagon-like peptide-1 (GLP-1) induced by a rapid arrival of nutrients to the distal gut suppresses glucagon secretion and may be a cause of LDS. In patients who underwent proctocolectomy, we observed no significant postoperative changes in EIA function, although there are some conflicting reports. It seems unlikely that ordinary pancreaticobiliary diversion would cause a significant change in EIA function after an oral glucose load. Our experimental model of ileojejunal transposition produced marked hypersecretion of incretin secreted from the distal gut, which may alter EIA function. Further elucidation of the regulatory mechanism of EIA may provide a new strategy for the medical and surgical treatment of LDS.

Original languageEnglish
Pages (from-to)370-378
Number of pages9
JournalPancreas
Volume16
Issue number3
DOIs
Publication statusPublished - 1998 Apr

Keywords

  • Enteroinsular axis
  • Gastrointestinal surgery
  • Incretin
  • Late dumping syndrome
  • Pancreaticobiliary diversion
  • Proctocolectomy

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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