Gastric intrinsic factor production and vitamin B-12 absorption after oesophageal resection using stomach as substitute

Objective: To investigate whether the use of the stomach as a substitute af ter oesophageal resections causes disturbances in vitamin B-12 absorption d ue to deficient intrinsic factor (IF) production. Material and methods: Ele ven patients operated upon with oesophageal resection a.m. Ivor Lewis, for malignant (10) or benign (1) conditions of the oesophagus were examined wit h a postoperative dual isotope technique 11-41 months (mean 25 months) afte r operation. Results: In two patients the test showed abnormally low absorp tion of vitamin B-12. One of these probably due to incomplete urine collect ion during the test period. However, no patient showed deficient intrinsic factor production with absorption ratios between vitamin B-12 +/- IF of 0.8 7-1.14 (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 B-12 absorption may be low due to other factors, and should be looked for in all patients survivin g more than a couple of months postoperatively. (C) 1999 Elsevier Science B .V. All rights reserved.