Skip to main content
Log in

Bone disorder following partial and total gastrectomy with reference to bone mineral content

  • Original Articles
  • Published:
The Japanese journal of surgery Aims and scope Submit manuscript

Abstract

To study post-gastrectomy metabolic bone disorders, we measured the radial bone mineral content (BMC), serum levels of calcium, inorganic phosphorus, alkaline phosphatase, and 25-hydroxyvitamin D(25-OH-D) in 59 patients with partial- and 39 patients with total gastrectomy. Total gastrectomy patients manifested a higher incidence of decreased BMC levels than did partial gastrectomy patients (56 per centvs. 25 per cent). Patients subjected to the Billroth II procedure, especially females, manifested abnormally low BMC values. The decline in BMC was age-related; it was pronounced in females. At 10 years postoperatively, many of the partial gastrectomy patients manifested markedly low BMC levels; in totally gastrectomized patients this finding was made at less than 5 years postoperatively. Approximately 30 per cent of our patients showed abnormalities in serum minerals, alkaline phosphatase or 25-OH-D.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Baird IM, Oleesky S. Osteomalacia following gastric surgery. Gastroenterology 1957; 33: 284–292.

    PubMed  CAS  Google Scholar 

  2. Deller DJ, Begley MD, Edwards RG, Addison M. Metabolic effects of partial gastrectomy with special reference to calcium and folic acid. Part I. Changes in calcium metabolism and the bones. Gut 1964; 5: 218–225.

    PubMed  CAS  Google Scholar 

  3. Williams JA. Effects of upper gastro-intestinal surgery on blood formation and bone metabolism Br J Surg 1964; 51: 125–135.

    PubMed  CAS  Google Scholar 

  4. Thompson GR, Lewis B, Booth CC. Vitamin-D absorption after partial gastrectomy. Lancet 1966; II: 457–458.

    Article  Google Scholar 

  5. Morgan DE, Paerson C, and Fourman P. Search for osteomalacia in 1228 patients after gastrectomy and other operations on the stomach. Lancet 1965; II: 1086–1091.

    Google Scholar 

  6. Eddy RL. Metabolic bone disease after gastrectomy. Am J Med 1971; 50: 442–449.

    Article  PubMed  CAS  Google Scholar 

  7. Fukuda M, Shibata H, Hatakeyama K, Yamagishi Y, Soga J, Koyama S, Muto T. Difference in calcium metabolism following Billroth-I and Billroth-II procedures for gastric and duodenal ulcers. Jpn J Surg 1979; 9: 295–303.

    Article  PubMed  CAS  Google Scholar 

  8. Hirota M. A clinical and histological evaluation of bone diseases following total gastrectomy. Jpn J Gastroenterol Surg 1982; 15: 1716–1727. (in Japanese)

    Google Scholar 

  9. Fukuda M, Hirota M. A therapeutic method for patients with postgastrectomy bone disease. Jpn J Gastroenterol Surg 1982; 15: 1513–1518. (in Japanese)

    Google Scholar 

  10. Pääkkönen M, Alhava EH, Karjalainen P, Korhonen R, Savolainen K, Syrjänen K. Long-term follow-up after Billroth I and II partial gastrectomy. Acta Chir Scand 1984; 150: 485–488.

    PubMed  Google Scholar 

  11. Cameron JR, Sorensen J. Measurement of bone mineralin vivo. An improved method. Science 1963; 142: 230–232.

    PubMed  CAS  Google Scholar 

  12. Bernett E, Nordin BEC. The radiological diagnosis of osteoporosis. A new approach. Clin Radiol 1960; 11: 166–176.

    Article  Google Scholar 

  13. Exton-Smith AN, Millard PH, Payne PR, Wheeler EH. Method for measuring quantity of bone. Lancet 1969; II: 1153–1154.

    Article  Google Scholar 

  14. Singh M, Nograth AR, Maini PS. Change in trabecular pattern of the upper end of the femur as an index of osteoporosis. J Bone Joint Surg 1970; 52: 457–467.

    PubMed  CAS  Google Scholar 

  15. Kócian J, Vulterinová M, Bejblová O, Skála I. Influence of lactose intolerance on the bones of patients after partial gastrectomy. Digestion 1973; 8: 324–335.

    Article  PubMed  Google Scholar 

  16. Cameron JR, Magess RE, Sorensen JA. Precision and accuracy of bone mineral determination by direct photon absorptiometry. Invest Radiol 1968; 3: 141–150.

    PubMed  CAS  Google Scholar 

  17. Manicourt DH, Orloff S, Brauman J, Schoutens A. Bone mineral content of the radius: Good correlations with physicochemical determinations in iliac crest trabecular bone of normal and osteoporotic subjects. Metabolism 1981; 30: 57–62.

    Article  PubMed  CAS  Google Scholar 

  18. Kishimoto H. Clinical study on bone mineral mass in metabolic bone disease125I-photon absorptiometry. J Jpn Orthop Ass 1983; 57: 1699–1715. (in Japanese)

    CAS  Google Scholar 

  19. Yamamoto K, Kishimoto H. Measurement of bone mineral content by bone mineral analyzer. In: Itami Y, Nishio A, Wakamatsu E. eds. Osteoporosis (Mook of Orthopedic Surgery; 34). Tokyo: Kanehara Inc, 1984; 36–46. (in Japanese)

    Google Scholar 

  20. Tougaard L, Rickers H, Rödbro P, Thaysen EH, Christensen MS, Lund B, Sörensen OH. Bone composition and vitamin D after Pólya gastrectomy. Acta Med Scand 1977; 202: 47–50.

    Article  PubMed  CAS  Google Scholar 

  21. Orimo H, Shiraki M. Role of calcium regulating hormones in the pathogenesis of senile osteoporosis. Endocrinol Japon 1979; S R I: 1–6.

    Google Scholar 

  22. Morita R, Yamamoto I, Fukunaga M, Dokoh S, Konishi J, Kousaka T, Nakajima K, Aso T, Motohashi T. Changes in sex hormones and calcium regulating hormones with reference to bone mass associated with aging. Endocrinol Japon 1979; R S I: 15–22.

    Google Scholar 

  23. Imawari M, Kozawa K, Akanuma Y, Koizumi S, Itakura H, Kosaka K. Serum 25-hydroxyvitamin D and vitamin D-binding protein levels after partial and total gastrectomy. Gastroenterology 1980; 79: 255–258.

    PubMed  CAS  Google Scholar 

  24. Gertner JM, Lilburn M, Domenech M. 25 Hydroxycholecalciferol absorption in steatorrhoea and post-gastrectomy osteomalacia. Br Med J 1977; I: 1310–1312.

    Article  Google Scholar 

  25. Lilienfeld-Toal HV, Mackes KG, Kodrat G, Ochs H, Sonnenberg A. Plasma 25-hydroxyvitamin D and urinary cyclic AMP in German patients with subtotal gastrectomy (Billroth II). Am J Dig Dis 1977; 22: 633–636.

    Article  Google Scholar 

  26. Nilas L, Christiansen C, Christiansen J. Regulation of vitamin D and calcium metabolism after gastrectomy. Gut 1985; 26: 252–257.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nishimura, O., Furumoto, T., Nosaka, K. et al. Bone disorder following partial and total gastrectomy with reference to bone mineral content. The Japanese Journal of Surgery 16, 98–105 (1986). https://doi.org/10.1007/BF02471078

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02471078

Key Words

Navigation