Relationships Between Gastric Emptying and Intestinal Absorption of Nutrients and Energy in Mini Pigs

Little is known about the relationship betweengastric emptying of nutrients regulated by feedbackmechanisms and the absorptive capacity of the gut.Therefore, we wanted to elucidate theseinterrelationships. A 150-cm jejunal segment was perfused (1-8kcal/min) with three different nutrient solutions(either 60% of energy as carbohydrate, or 60% asprotein, or 33.3% of each nutrient). In separateexperiments, gastric emptying was measured afteradministration of three different meals with the samenutrient composition as the perfusion solutions. Thejejunal absorption of carbohydrate, protein, fat, andenergy demonstrated saturation kinetics. The kineticsdiffered among the three nutrients; carbohydrates wereabsorbed at higher rates than fat and protein.Interactions among the nutrients altered the kinetics providing a constant absorption of energy.After meals, the stomach emptied equal amounts of energydespite large variations in meal composition. Theavailable intestinal absorptive capacity for protein was utilized by 96%, whereas that forcarbohydrate, fat and energy were utilized only by46-62%. Besides reserves in the absorptive capacity, theintestine provided reserves in total length available for absorption. The results indicate a closerelationship between the energy-dependent absorption ofnutrients and the energy-dependent feedback inhibitionof gastric emptying.     

The Mini-Gastric Bypass: Experience with the First 1,274 Cases

Background: Results of the laparoscopic Mini-Gastric Bypass (MGB) are reported. Methods: 1,274 MGB patients are continuously monitored as part of an online computer tracking data-base system. Results: Mean preoperative weight (± Standard Deviation) was 132 ± 21 kg, BMI 47 ± 7. Mean excess weight loss was 51% at 6 months, 68% at 12 months and 77% at 2 years. The mean operating-time was 36.9 ± 33.5 minutes. The shortest time was 19 minutes. Hospital stay was 1.5 ± 1.6 days. The overall complication rate has been 5.2%.The overall rate of deep vein thrombosis and pulmonary embolism was 0.08% and 0.16% respectively. The leak rate was 1.6%. There was one hospital death, 0.08%. Associated medical illnesses were either completely reversed or markedly improved. Conclusions: The MGB is safe, results in major weight loss, has a short operating-time, and has a short hospital stay.The MGB appears to meet many of the criteria of an "ideal" weight loss operation.