Postprandial Changes in Gastrointestinal Hormones and Hemodynamics after Gastrectomy in Terms of Early Dumping Syndrome
- Author:
Jun-Young YANG
1
;
Hyuk-Joon LEE
;
Fadhel ALZAHRANI
;
Seung Joon CHOI
;
Woon Kee LEE
;
Seong-Ho KONG
;
Do-Joong PARK
;
Han-Kwang YANG
Author Information
- Publication Type:Original Article
- From:Journal of Gastric Cancer 2020;20(3):256-266
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:This study aimed to examine the early postprandial changes in gastrointestinal (GI) hormones and hemodynamics in terms of early dumping syndrome after gastrectomy for gastric cancer.
Materials and Methods:Forty patients who underwent gastrectomy for gastric cancer and 18 controls without previous abdominal surgery were enrolled. Before and 20 minutes after liquid meal ingestion, blood glucose, glucagon-like peptide-1 (GLP-1), and GLP-2 concentrations and superior mesenteric artery (SMA) and renal blood flow were measured.The patients' heart rates were recorded at 5-minute intervals. All subjects were examined for dumping syndrome using a questionnaire based on Sigstad's clinical diagnostic index.
Results:The postprandial increases in blood glucose, GLP-1, and GLP-2 levels as well as SMA blood flow and heart rate were greater in patients who underwent gastrectomy than in controls (all P<0.010). Patients who underwent gastrectomy showed a significantly decreased renal blood flow (P<0.001). Among patients who underwent gastrectomy, distal gastrectomy was a significant clinical factor associated with a lower risk of early dumping syndrome than total gastrectomy (hazard ratio, 0.092; 95% confidence interval, 0.013–0.649; P=0.017).Patients who underwent total gastrectomy showed a greater postprandial increase in blood glucose (P<0.001), GLP-1 (P=0.030), and GLP-2 (P=0.002) levels as well as and heart rate (P=0.013) compared to those who underwent distal gastrectomy.
Conclusions:Early postprandial changes in GI hormones and hemodynamics were greater in patients who underwent gastrectomy than in controls, especially after total gastrectomy, suggesting that these changes play a crucial role in the pathophysiology of early dumping syndrome.
