To study the pathophysiology of altered appetite, weight loss and postprandial
hypoglycaemia after oesophagectomy. Method: Twelve consecutive patients undergoing
oesophagectomy were studied preoperatively and at 10 days, 6, 12, 52 weeks
postoperatively. Plasma glucagon-like peptide-1 (GLP-1), BA profile, insulin and glucose
responses to a 400kcal mixed-meal stimulus were determined. CT-body composition and
anthropometry were assessed, and EORTC HR-QL symptom scores computed. Result: At
one year, 16.7% of patients exhibited postprandial hypoglycaemia, associated with weight
loss (17.1±3.2%; P< 0.001), lean body mass loss (-4.0±0.9 kg, P= 0.003) and reduced
insulin resistance (HOMA-IR,-0.30±0.09, P= 0.008). Postprandial insulin increased
progressively at 10 days, 6, 12 and 52 weeks