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KMID : 0371319660080060325
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Journal of the Korean Surgical Society
1966 Volume.8 No. 6 p.325 ~ p.342
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Intestinal Absorption Test with Triolein in Digestive Diseases and Their Postoperative Conditions in Korean
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金子勳/Kim, Ja Hoon
金光宇/金秉洙/高昌舜/洪昌基/Kim, Kwang Woo/Kim, Byung Soo/Koh, Chang Soon/Hong, Changgi D.
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Abstract
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Fat absorption test using I^(131)-Triolein was performed in 6 normal subjects and 37 cases of digestive diseases and their postoperative conditions. In the 37 cases, there were 18 cases of gastrectomy(included three secondary checks), 6 cases of intestinal resection, 5 cases of biliary tract disease(gallstone, 4: benign stricture, 1: included two cases of pre-and post-operative checks), 2 cases of liver disease(cirrhosis, 1: cancer, 1), 2 cases of pancreatic disease(pancreatitis, 1: cancer, 1) and 4 cases of gastrointestinal disease(stomach ulcer, 2: gastrojejunocolic fistula, 1: Whipple´s disease, 1).
The results obtained are as follows:
1) Fecal excretion of I^(131)-Triolein in 6 normal persons ranged from 2.10% to 3.93%, with a mean value of 2.79%±S.D. 0.7.
2) In gastrectomy group, when examined 2 months to 19 months after operation, 15(84%) of 18 cases showed an increase in fecal excretion of I^(131)-Triolein, which ranged from 4.60% to 17.40% with an average of 8.43%. The mean fecal value with regard to the primary disease was 10.24% in patients with peptic ulcer and 5.56% in patients with cancer; the former was 4.68% higher than the latter, without statistical significance(p＞0.2), and there was also no significant difference(p＞0.3) between Billroth Ⅱ group(mean value: 8.16%) and Billroth I with jejunal transposition group(mean value: 9.52%).
3) Postgastrectomy malabsorption of I^(131)-Triolein was noted even in the "excellent" group of postoperative results which indicated satisfactory findings in every clinical or laboratory examination.
4) In the group with extensive resection of small intestine, at intervals of 2 months to 56 months following operation, all of the cases showed a marked increase of fecal I^(131)-Triolein, of which range was 15.50% to 34.10%, with a mean value of 22.60%; this was not exception in cases of less extensive resection as removal or by-pass of ileoceal junction.
5) Weight loss of mild to moderate degree was present only in 22% of gastrectomy group, and the difference between Billroth Ⅱ and jejunal transposition group without significance, whereas of moderate to marked degree in all cases of small intestinal resection.
Anemia and hypoproteinemia may be neglected in both groups, with relatively high incidence of anemia in intestinal resection group.
6) Malabsorption or weight loss after gastrectomy or intestinal resection showed little improvement with the passage of time, until up to 56 months after instestinal resection, and there was a very poor correlation between the body weight and the percentage of fecal I^(131)-Triolein in both groups.
7) In digestive diseases such as hepatobiliary, pancreatic and gastric lesions and a Whipple´s disease, there was a constant increase of fecal excretion, which was considerably improved after surgical or medical treatment, but did not return to normal value in the majority.
8) The mean peak value of blood radioactivity in normal individuals was approximately 11.00%. The peak values of the patients with excessive fecal I^(131)-Triolein excretion were generally lower than those of normal subjects, but not consistent with the abnormal increase in fecal radioactivity; it is thus said that blood value is less diagnostic in the radio-iodine fat absorption test.
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KEYWORD
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