Dahm K, Knipper A, Eichfuss H P, Werner B, Breucker H
Dtsch Med Wochenschr. 1976 Dec 17;101(51):1883-4.
Various forms of operative duodenal exclusion with or without duodenogastric reflux were performed on 54 male Wistar rats. It was demonstrated that after duodenal exclusion with reflux peptic ulcers regularly occur at the site of anastomosis. Continuous reflux of bile and pancreatic secretion is the decisive factor in the development of ulcer at the anastomotic border between stomach and jejunum. Stasis in the excluded duodenum (syndrome of the afferent loop) promotes the ulcerogenic reflux effect. If there is no pylorus, reflux and stasis are potentiated to the highest incidence of ulcer (more than 90%). These results indicate that operations with duodenal exclusion and reflux (Billroth II) should be discontinued.
对54只雄性Wistar大鼠进行了各种形式的手术十二指肠切除术，伴或不伴十二指肠胃反流。结果表明，十二指肠切除并伴有反流时，吻合口部位经常会发生消化性溃疡。胆汁和胰液的持续反流是胃空肠吻合口边缘溃疡形成的决定性因素。被切除十二指肠的淤滞（输入袢综合征）会增强致溃疡的反流效应。如果没有幽门，反流和淤滞会使溃疡发生率升高到最高水平（超过90%）。这些结果表明，应停止进行伴有十二指肠切除和反流的手术（毕罗Ⅱ式手术）。
