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Effects of Enterectomy on Postoperative Visceral Organ Glucose Exchange
Author(s) -
Souba Wiley W.,
Roughneen Patrick T.,
Goldwater Diane L.,
Reed R. Lawrence,
Rowlands Brian J.
Publication year - 1989
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607189013002128
Subject(s) - gluconeogenesis , medicine , endocrinology , kidney , glucose homeostasis , homeostasis , enteral administration , carbohydrate metabolism , gastrointestinal tract , parenteral nutrition , short bowel syndrome , metabolism , biology , insulin , insulin resistance
The effects of a 60% small‐bowel resection on postoperative visceral organ glucose exchange was studied in order to gain further understanding of the role of the intestinal tract as a supplier of gluconeogenic substrate to the liver following operative stress. We determined the flux of glucose across the gastrointestinal tract, liver, and kidneys in 20 postoperative dogs. With enterectomy portal bloodflow and total hepatic bloodflow were diminished by 33% and 25%, respectively. Arterial glucose was slightly lower in the enterectomized group 6 hr following the operation. Intestinal glucose uptake was diminished by more than 50% in the enterectomized dogs (p < 0.01). Net hepatic glucose release fell from 22 μmole/kg/ min to 8 μmole/kg/min (p < 0.01). In control animals the kidney was an organ of slight glucose uptake while in the enterectomized group, the kidney released glucose at the rate of 4.1 μmole/kg/min (p < 0.05). The data suggest that the gut is an important supplier of gluconeogenic precursors to the liver which are used to support gluconeogenesis in the postoperative period. The ability of the kidney to accelerate glucose production in this setting suggests that metabolic adaptation and cooperation between organs occurs during organ absence or dysfunction which helps preserve glucose homeostasis. ( Journal of Parenteral and Enteral Nutrition 13 :128–131, 1989)