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Eur J Cardiothorac Surg 1999;16:273-275
© 1999 Elsevier Science NL

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

^a Department of Cardiothoracic Surgery, Aalborg Hospital, Aalborg, Denmark
^b Department of Medical Gastroenterology, Aalborg Hospital, Aalborg, Denmark

Corresponding author. Heart Centre, University Hospital, S-901 85 Umea, Sweden. Tel.: +46-90-785-3610; fax: +46-90-785-3601

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.

Key Words: Oesophageal resection • Vitamin B₁₂ • Intrinsic factor • Oesophageal cancer