A Study of the Difference in Intestinal Adaptation between the Residual Jejunum and the Ileum in Rats with Short Bowel Syndrome

Objectives : Controversy remains regarding which residual segment, namely the jejunum or ileum, is more beneficial for intestinal adaptation in patients with short bowel syndrome (SBS). The aim of our study is to evaluate the residual intestinal adaptation after a massive small intestinal resection and thereby determine which of the two residual segments demonstrates a better intestinal adaptation. Methods : The SBS rats underwent about a 70 % resection of either the jejunum or ileum, respectively. Sham rats underwent an ileal transection with a subsequent reanastomosis of the same portion. The body weight was measured every day after the operation. Two weeks after the operation, all rats were sacrificed. The intestinal length, the hematological and serum chemical data, and the histological findings of the residual intestine were investigated in all rats to evaluate the intestinal adaptation. Results : The body weight gain in the rats with the residual ileum (ileum group) was similar to that of the Sham group and better than that of the rats with residual jejunum (jejunum group). The length of the residual intestines in the jejunum group was longer than that in both the sham and ileum groups. Regarding hematological and serum chemical studies, the jejunum group tended to demonstrate more anemia and malnutrition than both the sham and ileum groups. In a histological study, the villous height in both the jejunum and ileum groups was significantly larger than in the preoperative condition. In both groups, the degree of crypt depth only significantly increased in the ileum group in comparison to the preoperative condition. Regarding the thickness of the muscular layers, a no difference was observed among all groups. Conclusion : Based on our data, in patients with SBS, the use of the residual ileum was thereforefound to be preferable to that of the residual jejunum regarding intestinal adaptation