European Journal of Anatomy

Official Journal of The Spanish Society of Anatomy
Cover Volume 24 - Number 2
Eur J Anat, 24 (2): 135-140 (2020)

A surgical study about jejunum: the exclusion to nutrients flow. A novel strategical technique

Alejandra Moreno-Arciniegas2, Marcos Vilches-Aguilera4, Alonso Camacho-Ramírez1,3,6, David Almorza-Gomar5, Gonzalo M. Pérez-Arana3,4,6, J. Arturo Prada-Oliveira3,4,6

1Surgery Unit, Puerta del Mar Hospital, University of Cádiz, 2Surgery Unit, Ceuta Hospital, INSALUD, 3INIBICA, Research Biomedical Institute of Cadiz, University of Cadiz, 4Department of Human Anatomy and Embryology, Faculty of Medicine, University of Cádiz, 5Department of Operative Statistic and Research. University of Cádiz, 6AGAI. Cadiz Researcher Support Association. Cádiz

ABSTRACT The bariatric surgery techniques applied in pa-tients with obesity have reported a great ability to improve Type 2 Diabetes mellitus (T2DM). Some published data report an increasing beta-cell mass in some surgical processes. This mechanism was specially seen in the bariatric surgeries which af-fect the length of the small bowel. The intrinsic mechanism that links both phenomena seemed to be related to the enterohormonal secretion pattern. Many enteral hormones have been invoked as the effector of these mechanisms. Previous reports focused on the medial portion of jejunum, as the precise place in which some particular enterohor-mones determine the homeostatic glycemic im-provement. Goto-Kakizaki diabetic male rats un-derwent surgery to exclude the 50% medial jeju-num from the normal nutrients flow. This medial portion of jejunum was not resected, but anasto-mosed by both extremes to the abdominal wall, and a stoma was performed. This surgery wasnamed as Medial Jejunal Exclusion (MJE). We studied the functional parameters in a three-month survival period. In this sense basal glycaemia, weight increase and food intake were not modified between the surgical and control groups. The study presented a mortality of the 24%. This model was designed for the late study of serum and en-terohormones release in this jejunal portion, ex-cluded of nutrients flow. We report a new surgical technique, which appears to balance the homeo-static processes in order to maintain the survival of diabetic rats. Thus, this mechanism could be in the basis of T2DM improvement, and this novel surgi-cal model will help study this precise portion of jejunum.

Keywords: Jejunum – Type 2 Diabetes mellitus – Malabsorption syndrome – Animal models – Gas-trointestinal-hormones

European Journal of anatomy
ISSN 2340-311X (Online)