Jin-Ming Wu1, Ching-Yao Yang2, Ting-Chun Kuo2, Hong-Shiee Lai2, Pin-Yi Chiang3, Su-Hua Hsieh3, Yu-Wen Tien4. 1. Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, 7 Chung-Shan South Rd., Taipei, 10002, Taiwan, Roc. kptkptkpt@yahoo.com.tw. 2. Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, 7 Chung-Shan South Rd., Taipei, 10002, Taiwan, Roc. 3. Department of Nursing, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan, Roc. 4. Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, 7 Chung-Shan South Rd., Taipei, 10002, Taiwan, Roc. ywtien5106@ntu.edu.tw.
Abstract
BACKGROUND: The change in the route of food passage after pancreaticoduodenectomy (PD) is quite similar to the change after gastric bypass surgery; both procedures bypass the duodenum and directly connect to the distal jejunum. Moreover, both procedures result in resolution of type 2 diabetes mellitus. Therefore, more distal enteral anastomosis after PD may further improve glycemic status. METHODS: To test the effect of distal enteral feeding on glucose metabolism in patients after PD, we performed a meal test on 20 patients via a nasogastric tube [proximal feeding group (PFG)] on post-operative day 5 and then via an intra-operatively placed jejunostomy feeding tube [distal feeding group (DFG)] on post-operative day. Blood samples were assessed for hormones and glucose. RESULTS: The AUC0-120 min levels of GLP-1, C-peptide, and insulin after distal feeding were significantly higher than after proximal feeding. The AUC0-120 min levels of glucose in the DFG were significantly lower than in the PFG. CONCLUSIONS: More distal enteral feeding contributed to better glucose metabolism after PD.
BACKGROUND: The change in the route of food passage after pancreaticoduodenectomy (PD) is quite similar to the change after gastric bypass surgery; both procedures bypass the duodenum and directly connect to the distal jejunum. Moreover, both procedures result in resolution of type 2 diabetes mellitus. Therefore, more distal enteral anastomosis after PD may further improve glycemic status. METHODS: To test the effect of distal enteral feeding on glucose metabolism in patients after PD, we performed a meal test on 20 patients via a nasogastric tube [proximal feeding group (PFG)] on post-operative day 5 and then via an intra-operatively placed jejunostomy feeding tube [distal feeding group (DFG)] on post-operative day. Blood samples were assessed for hormones and glucose. RESULTS: The AUC0-120 min levels of GLP-1, C-peptide, and insulin after distal feeding were significantly higher than after proximal feeding. The AUC0-120 min levels of glucose in the DFG were significantly lower than in the PFG. CONCLUSIONS: More distal enteral feeding contributed to better glucose metabolism after PD.
Authors: S Camastra; A Gastaldelli; A Mari; S Bonuccelli; G Scartabelli; S Frascerra; S Baldi; M Nannipieri; E Rebelos; M Anselmino; E Muscelli; E Ferrannini Journal: Diabetologia Date: 2011-05-26 Impact factor: 10.122
Authors: M Nannipieri; A Mari; M Anselmino; S Baldi; E Barsotti; D Guarino; S Camastra; R Bellini; R D Berta; E Ferrannini Journal: J Clin Endocrinol Metab Date: 2011-07-21 Impact factor: 5.958