Postoperative adaptation of the small intestine

摘要: For nearly 100 years, the small intestine has been known to compensate for partial tissue loss. only some 20 years phenomenon studied in any depth, and a proportion of these investigations undertaken humans. Experimental clinical data show that enteric mucosal hyperplasia remaining bowel after resection or bypass is accompanied by cytokinetic functional adaptation. In general, degree adaptation depends on 3 factors: amount excised excluded, particular segment involved, presence absence normal luminal stream. Thus, massive enterectomy can overwhelm adaptive capacity gut, loss jejunum better tolerated than terminal ileum, total parenteral nutrition will abolish compensatory response. The mechanisms govern change are complex interrelated. They involve both agents (food, alimentary secretions) humoral influences, which enteroglucagon appears be most important. Wherever possible, operations should take account phenomena order minimize metabolic nutritional sequelae.