Research Article| Volume 57, ISSUE 2, P291-296, February 1965

Fat absorption and the afferent loop

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      An attempt was made to correlate Billroth II gastrectomy in steatorrhea in dogs with the length of the afferent loop. With greater lengths of afferent loop, increasing steatorrhea was noted.
      Qualitative and quantitative bacteriologic studies of the duodenum were carried out before and after creation of an afferent loop. Postoperatively, there was very little change in bacterial content with different lengths. Antibiotics which reduced the bacterial count of the afferent loop did not mitigate the steatorrhea.
      This study indicates that postgastrectomy steatorrhea with a Billroth II anastomosis is related to the length of the afferent loop, although the precise physiologic mechanism is not clear. Possible explanations for the steatorrhea are discussed.
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        • Anderson C.M.
        • Frazer A.C.
        • French J.M.
        • Gerrand J.W.
        • Sammons H.G.
        • Smellie J.M.
        Coeliac disease: Gastrointestinal studies and the effect of dietary wheat flour.
        in: ed. 2. Lancet. 19. 1952: 836
        • Annegers J.H.
        • Boutwell J.H.
        • Ivy A.C.
        The effect of dietary fat on fecal fat excretion and subjective symptoms ia man.
        Gastroenterol. 1948; 10: 486
        • Annis D.
        • Hallenbeck G.A.
        Some effects of partial gastrectomy on canine external pancreatic secretion.
        Surgery. 1952; 31: 517
        • Butler T.J.
        • Copper W.M.
        • Naish J.M.
        Ileo-jejunal insufficiency following different types of gastrectomy.
        Gastroenterol. 1954; 81: 104
        • Everson T.C.
        Experimental comparison of protein and fat assimilation after BII, BI and segmental types of subtotal gastrectomy.
        Surgery. 1954; 36: 525
        • Glazebrook P.J.
        • Welbourn R.B.
        Some observations on the function of the small intestine after gastrectomy.
        Brit. J. Surg. 1952; 40: 111
        • Goldstein F.
        • Wirts C.M.
        • Kramer S.
        The relationship of afferent limb stasis and bacterial flora to the production of postgastrectomy streatorrhea.
        Gastroenterol. 1960; 40: 47
        • Hertel E.
        Experimentelle Untersuchungen über den einfluss der magenresektion auf die Verdauung im Dünndarm.
        Arch. f. klin. Chir. 1929; 156: 66
        • Jansson B.
        • Tyor M.P.
        • Owen E.E.
        • Ruffin J.M.
        Absorption of I131 labeled lipids after intraduodenal administration: Effect of lipid prefeeding.
        Gastroenterol. 1960; 38: 211
        • Kiekers R.
        • Lundh G.
        Intestinal digestion and absorption after Billroth II gastrectomy.
        Acta chir. scandinav. 1957; 113: 349
        • Kremen A.J.
        • Linner J.H.
        • Nelson C.H.
        An experimental evaluation of the nutritional importance of proximal and distal small intestines.
        Ann. Surg. 1954; 140: 439
        • Lundh G.
        Intestinal digestion and absorption after gastrectomy.
        Acta. chir. scandinav. Supp. 1958; 231: 1
        • MacLean L.D.
        • Perry J.F.
        • Kelly W.D.
        • Mosser D.G.
        • Mannick A.
        • Wangensteen O.H.
        Nutrition following subtotal gastrectomy of four types.
        Surgery. 1954; 35: 705
        • Meleney F.C.
        • Berg B.N.
        • Jobling J.W.
        Experimental chronic duodenal obstruction.
        Arch. Surg. 1927; 14: 762
        • Polak M.
        • Fernandes-Pontes J.
        The cause of postgastrectomy steatorrhea.
        Gastroenterol. 1956; 30: 489
        • Saxon E.
        • Ziese L.
        Weight loss after gastrectomy.
        Surgery. 1960; 48: 666
        • Shingleton W.W.
        • Isley J.K.
        • Floyd R.D.
        • Sanders A.P.
        • Boylin G.J.
        • Postlethwait R.W.
        • Ruffin J.M.
        Studies on postgastrectomy steatorrhea using radioactive triolein and oleic acid.
        Surgery. 1957; 42: 12
        • Starzl T.E.
        • Butz G.W.
        • Hartman C.F.
        The blind-loop syndrome after gastric operations.
        Surgery. 1961; 59: 849
        • Van de Kamer J.H.
        • Tenbokkel Hulnink H.
        • Meyers H.A.
        Rapid method for the determination of fat in feces.
        J. Biol. Chem. 1949; 177: 347
        • Waddell W.R.
        • Wang C.C.
        Effect of vagotomy on gastric evacuation of high fat meals.
        J. Appl. Physiol. 1952; 5: 705
        • Welbourn R.B.
        • Hallenbeck G.A.
        • Bollman J.L.
        Effect of gastric operations on loss of fecal fat in the dog.
        Gastroenterol. 1953; 23: 441
        • Wollaeger E.E.
        • Comfort M.W.
        • Weir J.F.
        The total solids, fat and nitrogen in the feces. I. A study of normal persons and of patients with duodenal ulcer on a test diet containing large amounts of fat.
        Gastroenterol. 1946; 6: 83
        • Wollaeger E.E.
        • Comfort M.W.
        • Weir J.F.
        The total solids, fat and nitrogen in the feces. II. A study of persons who had undergone partial gastrectomy with anastomosis of the entire cut end of the stomach and the jejunum.
        Gastroenterol. 1946; 6: 93
        • Wollaeger E.E.
        • Waugh J.M.
        • Power M.H.
        Fat-assimilating capacity of the gastrointestinal tract after partial gastrectomy with gastroduodenostomy.
        Gastroenterol. 1963; 44: 25