Role of extrinsic innervation in jejunal absorptive adaptation to subtotal small bowel resection: A model of segmental small bowel transplantation

Karen D. Libsch, Nicholas J. Zyromski, Toshiyuki Tanaka, Michael L. Kendrick, Jaime Haidenberg, Daniela Peia, Matthias Worni, Judith A. Duenes, Louis J. Kost, Michael G. Sarr

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Segmental small bowel transplantation offers theoretic advantages over total jejunoileal transplantation, but the regional ability of the transplanted segment to adapt is unknown. Absorption was measured in an 80 cm jejunal segment via a triple-lumen perfusion technique. Separate experiments measuring absorption of four nutrients (glucose, glutamine, oleic acid, and taurocholic acid) were performed before and 2 and 12 weeks after operative intervention. Control dogs (CON, n = 6) underwent distal 50% enterectomy. Experimental dogs (EXT DEN, n = 6), in addition to resection, underwent complete extrinsic denervation of the remaining jejunum. All dogs developed diarrhea, which rhesolved in all CON dogs but persisted in all EXT DEN dogs. Maximal weight loss was greater in the EXT DEN group. Glucose and oleate absorption was decreased 2 weeks after ileal resection in both the CON and EXT DEN dogs; glutamine absorption was decreased at 2 weeks in EXT DEN dogs only. Taurocholate and water absorption remained unchanged in both groups. Absorption of all solutes returned to baseline at 12 weeks in both groups. Despite greater weight loss and persistent diarrhea in EXT DEN dogs, at 12 weeks there were no differences in net absorptive fluxes between the EXT DEN and the CON group after extrinsic denervation. The extrinsic denervation necessitated by small bowel transplantation does not appear to blunt the net jejunal adaptive response to total ileal resection, but may temporarily alter glutamine absorption.

Original languageEnglish (US)
Pages (from-to)240-247
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume6
Issue number2
DOIs
StatePublished - Dec 1 2002
Externally publishedYes

Keywords

  • Bile acid absorption
  • Extrinsic denervation
  • Fat absorption
  • Glucose absorption
  • Glutamine absorption
  • Intestinal adaptation
  • Small bowel transplantation

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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