Study of Bone Metabolism, Intestinal Absorption and Anemia in Long Courses after Total Gastrectomy

Ryuji Momose

First Department of Surgery, Juntendo University, School of Medicine

Patients were examined after total gastrectomy for bone metabolism, intestinal absorption, and anemia to determine pathology by comparison of long and short postoperative courses (group L and S respectively). The subjects, 31 patients in group L and 21 in group S, were classified into two categories according to surgical procedure: jejunal interposition (41 cases) and Roux-en-Y (11 cases). Incidence of bone metabolic disorders was 57.1% for group S and 42.9% for group L; the difference was not significant, nor did the incidence show any difference between the two groups when stratified by surgical procedure and age. Intestinal absorption of protein and fat was poorer in group L than in group S. In paticular, poor absorption was prevalent in cases of Roux-en-Y where the duodenum was bypassed. Anemia was noted in 44.4% of patients from group S and 55.6% from group L; iron deficiency anemia tended to occur during the early postoperated period, whereas erythroblastic anemia tended to develop during the extended postoperative period. These result indicate that periodic dietary guidance and checks for anemia are required during the extended post-operative period and that duodenal bypass should be avoided when possible.

Key words
long courses after total gastrectomy, bone metabolic disorders, microdensitometry, intestinal absorption, anemia.

Reprint requests
Ryuji Momose First Department of Surgery, Juntendo University School of Medicine
2-1-1 Hongo, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
October 11, 1990

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