Effect of duodenal switch procedure on gastric acid production, intragastric pH, gastric emptying, and gastrointestinal hormones

Neil T. Welch, Akihiro Yasui, Choong B. Kim, Antony P. Barlow, Ronald A. Hinder, Tom R. DeMeeSter, Paul V. Polishuk, Geoffrey W.B. Clark, Thomas E. Adrian

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)

Abstract

The duodenal switch operation preserves the pylorus and the proximal 3 to 7 cm of duodenum in continuity with the stomach while diverting pancreaticobiliary secretions. We compared it with the Roux-en-Y without vagotomy or antrectomy in 12 dogs with innervated gastric pouches. Acid secretion was inhibited between tests using ranitidine in the Roux-en-Y group only, but two of the six dogs still developed stomal ulcers and the remainder showed stomal hyperemia. This may be due to a significant increase in gastric acid output after Roux-en-Y, but gastric emptying and plasma gastrin, cholecystokinin, secretin, gastric inhibitory polypeptide, peptide YY, and neurotensin were similar after both procedures. In 12 patients and a further 6 dogs, the duodenal switch caused no significant change in the intragastric pH environment as assessed by intragastric pH monitoring. The duodenal switch is a suitable procedure for pancreaticobiliary diversion.

Original languageEnglish
Pages (from-to)37-45
Number of pages9
JournalThe American Journal of Surgery
Volume163
Issue number1
DOIs
Publication statusPublished - Jan 1992
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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