Gastric intrinsic factor production and vitamin B12 absorption after oesophageal resection using stomach as substitute.

OBJECTIVE

To investigate whether the use of the stomach as a substitute after oesophageal resections causes disturbances in vitamin B12 absorption due to deficient intrinsic factor (IF) production.

MATERIAL AND

METHODS

Eleven patients operated upon with oesophageal resection a.m. Ivor Lewis, for malignant (10) or benign (1) conditions of the oesophagus were examined with a postoperative dual isotope technique 11-41 months (mean 25 months) after operation.

RESULTS

In two patients the test showed abnormally low absorption of vitamin B12. One of these probably due to incomplete urine collection during the test period. However, no patient showed deficient intrinsic factor production with absorption ratios between vitamin B12 +/- IF of 0.87-1.14 (reference interval: 0.70-1.20).

CONCLUSION

Deficiency of intrinsic factor is neither an obligatory nor a common occurrence after oesophageal resection with gastric substitute. However, vitamin B12 absorption may be low due to other factors, and should be looked for in all patients surviving more than a couple of months postoperatively.