BIOCHEMICAL LABORATORY DATA IN PATIENTS BEFORE AND AFTER RESTORATIVE PROTOCOLECTOMY - A STUDY ON 83 PATIENTS WITH A FOLLOW-UP OF 36 MONTHS

From 1980 to 1987 ileonal pouches were made in 83 patients. Specimen f or a set of laboratory analyses were taken preoperatively, during the ileostomy and loop ileostomy periods and repeatedly during 36 months o f follow-up. Cobalamine absorption and C-14-triolein breath tests were performed preoperatively in electively operated patients and postoper atively in all patients at 12 and 36 months. Low S-Ca was most pronoun ced preoperatively in patients who were to undergo acute colectomy (53 %). Decreased S-Mg was detected in 16-36% at all stations. None had si gns or symptoms of hypomagnesemia. Low S-albumin was rarely seen excep t for preoperatively in acute patients. Increased IgM was found in 40% of the patients during the loop ileostomy phase compared to 6-10% pre operatively Substantially increased orosomucoid and/or haptoglobin wer e seen in patients during the functional periods but these increased v alues could not be correlated to episodes with acute pouchitis. High v alues of S-ALAT and ALP were much more frequent during the loop ileost omy periods than it was preoperatively and during pouch function. Low S-haemoglobin and/or iron were noticed during the functional period in 3-8% and 10-16%, respectively. Severe anaemia, due to iron deficiency developed in one patient after 2.5 years of pouch function. Preoperat ively, slight decreases of S-B 12 were found in 13% and impaired cobal amine absorption was revealed in 38% of the electively operated patien ts. The corresponding figures were 3% and 31% after 12 months and 5% a nd 36% after 36 months of follow-up, respectively. B12 substitution wa s given to in all 8 patients during the follow-ups. Lipid absorption w as disturbed in 38% preoperatively and in 35% and 41% at 12 and 36 mon ths, postoperatively.