Gastrin: a new branch of the gastropancreatic axis that can explain the effect of sleeve gastrectomy on glucose metabolism.

BACKGROUND: Among bariatric techniques, sleeve gastrectomy (SG) stands out owing to its efficiency. The role of the stomach as a secretory organ of many substances, such as gastrin, related to insulin secretion is well known. Gastrin induces insulin release in isolated pancreatic islets, limiting somatostatin-14 intraislet release, and has been associated with blood glucose level improvement in diabetic models after SG. SG involves gastric resection along the greater curvature. This study aimed to determine the role of gastrin in glucose metabolism improvement after SG with the aid of the gastrin antagonist netazepide. METHODS: In 12 sham-operated, 12 SG-operated, and 12 SG-operated/netazepide-treated Wistar rats, we compared medium- and long-term plasma insulin, oral glucose tolerance test (OGTT) results, and plasma gastrin levels. In addition, gastrin expression was assessed in the gastric remnant, and the beta-cell mass was measured. RESULTS: SG induced a medium-term elevation of the insulin response and plasma gastrin levels without modification of the OGTT results. However, long-term depletion of the insulin response with elevated OGTT areas under the curve and plasma gastrin levels appeared after SG. Netazepide prevented the SG effect on these parameters. Gastrin tissue expression was greater in SG animals than in SG/netazepide-treated or control animals. The beta-cell mass was lower in the SG group than in the control or SG/netazepide group. CONCLUSION: Gastrin plays a central role in glucose improvement after SG. It stimulates a medium-term strong insulin response but also causes long-term beta-cell mass depletion and a loss of insulin response. These effects are prevented by gastrin antagonists such as netazepide.

Spermatic cord dermoid cyst as paratesticular mass. Case report and bibliographic review.

OBJECTIVE: Presentation of a new case of dermoid cyst of the spermatic cord and to perform a review of the literature. METHODS: We describe the case of a 48 year-old male who consulted because of reappearance of a mass in the left high scrotal area and inguinal zone. He was operated for left inguinal hernia two years before. RESULTS: Since physical examination and ultrasound were inconclusive, we performed a surgical exploration with complete excision of the mass. Intraoperartive pathologic analysis confirmed the benign nature of the mass so we did not proceed to radical orquiectomy. CONCLUSIONS: Among paratesticular tumors, benign in the majority of cases, dermoid cyst is a rare pathology of the spermatic cord that the clinician always has to take into account before making a decision when we treat the spermatic cord masses.