The new double tracing method with 1251-Triolein and 51Cr2C3 enabled the further study for the
absorptive function of digestive tract in various diseases and post-porative conditions, while the
conventional 1311-Triolein absorption test had the technical complexity and economical inefficiency. Total of 186 experiments were performed and the results obtained were as follows:
1) The normal value of fecal fat excretion rate in Korean population ranged around 2.9±0.77
(S.D.)%, which was below 5% of the ingested fat.
2) The measurement of radioactive fecal fat excretion was considered to be the ideal method to determine the assimilation failure during the digestion and the absorption in the digestive tracts in various diseases and post-operative conditions. In the liver diseases those caused digestive failure, the mean value was 7.6±2.99%, which was 4.7% higher than the normal individuals. (P<0.005) Especially among these, there was moderate to highly increased fecal fat excretion in more than 70% of the patients. It was severe in liver cirrhosis with or without cancer, while relatively mild in
hepatitis. In biliary disease group, the mean value was 7.4±1.67%. It was 4.5% increased than normal (P<0.005), and its incidence rate was more than 80%. The obstructive type showed the moderately severe fecal fat excretion. In pancreatic diseases, the mean value was 7. 4±2. 90%, which was 4. 5% increased than normal (P<0.005), and its incidence rate was about 70%. Pancreatic head tumor confirmed by operation and recurrent pancreatitis had more fecal fat excretion than the tumor sited in pancreatic tail. Particularly in those associated with stenosis of Ampulla of Vater showed 11. 95% of fecal fat excretion.
3) In 11 cases of small intesinal resection, the fecal fat excretion renged from 7% to 28. 7% with its mean value of 16.8±5.83%, which was 14% increased than normal. (P<0.005).
4) The stomacn cancer and peptic ulcer group showed the mean value of 7.8±1.47% and 8. 5± 2.87% respectively, which were relatively higher than normal.
5) In post-gastrectomy group, the mean value of fecal fat excretion was 7. 1±3. 16%, which showed
less_. improvement than the original disease group. Its cause was considered that the _ digestion and absorption failure were not significantly related to the poor´ reservoir function of totally or partially resected stomach, but to the impaired retaining function of ingested food of stomach and rapid transit time of the small intestine.
6) Among 4 operational procedures that author performed: Billroth II, Billroth I, Billroth I with jejunal transposition and antrum preserving operation, the fecal fat excretion ranged from 2. 2% to 12. 7% with the mean value of 7. 9±2. 65% for Billroth II operation, and from 2. 1% to 5.9% with the mean value of 3.9±1.38% for the antrum preserving operation. In respect of improving general condition and absorption rate of digestive tracts after operation, the antrum preserving operation was considered to be the best method for gastrectomy, if other conditions permitted.
7) In 55 post-gastrectomy cases, blood Hb and fecal fat excretion rate were found to have a constant linear correlation (Y=18.92-1.01 X), in which correlation coefficiency was r= 0. 436.
8) The gain and loss of post-operative body weight was poorly related to the intestinal fat absorption and the serum protein level.
9) In post-operative group, the intestinal transit time, the most reliable factor of the intestinal malabsorption was considerably related to the fecal fat excretion rate. In the group with Billroth II type gastrectomy, of which fecal fat excretion rate was somewhat high, and the time of terminal
ileum passage was 240 min., while it was 360 min, in antrum preserving operation group, which was slower than normal.
10) In the small intestinal resection cases, the fecal fat; excretion rate was proved to be poorly related to the operation site and its length; the whole small intestine including the terminal ileum took part in the absorptive function. In a case of ileocolostomy with blind loop when examined 44 months. after operation, the fecal excretion rate and body weight were not perfectly restored. Large intestine was not related to the fat digestion and absorption.
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