Outcomes and Perioperative Nutritional Management in a Porcine Model of Short Bowel Syndrome

BACKGROUND: Short bowel syndrome (SBS) results from significant intestinal loss and is characterized by insufficient absorption of nutrients and fluids. Preclinical large animal SBS models typically require parenteral nutrition (PN) support and may not be appropriate for studying interventions to improve intestinal absorption or adaptation. Here, we describe development of a porcine SBS model that does not require PN support. METHODS: Eight male Yorkshire piglets underwent either a 75% or 90% jejunoileal resection (n=5) or no resection (n=3). Continuous enteral nutrition (EN) was provided via gastrostomy tube. The final SBS model consisted of a 75% resection, and nutrition provided via combination EN (60%) and per oral pig chow (40%). Body weight and concentration of fat-soluble vitamins were assessed on post-operative days (POD) 7, 14, and 21. To assess fat malabsorption, the coefficient of fat absorption (CFA) was calculated following a 72-hour stool collection. RESULTS: Resected animals had decreased weight gain compared to unresected controls (POD21 +8.3% vs. +28.8%, P=0.048). Vitamin D concentration was significantly lower in resected animals compared to controls on POD 7, POD 14, and POD 21. Serum vitamin E concentration was also lower on POD 21. Resected animals developed fat malabsorption with lower CFA (76.5% vs. 95.3%, P=0.014). CONCLUSIONS: We describe the development of a porcine SBS model that does not require PN support. Piglets in this model gain less weight, demonstrate fat malabsorption, and develop fat-soluble vitamin deficiencies. This model will benefit investigations of intestinal absorption or adaptation, while potentially decreasing costs and confounding complications related to PN administration.