Donahue P E
Department of Surgery, Cook County Hospital, 1835 W. Harrison Street, Chicago, Illinois 60612, USA.
World J Surg. 2000 Mar;24(3):264-9. doi: 10.1007/s002689910043.
Patients with peptic ulcer occasionally develop complications that require surgical intervention, despite the advances in medical treatment and changes in the natural history of disease. The clinical surgeon must make a decision about performing "selective vagotomy antrectomy versus highly selective vagotomy," based on the information discussed herein. The goals for operative treatment remain safe correction of the presenting problem, avoidance of perioperative morbidity and mortality, and freedom from disabling postoperative side effects. This paper addresses broad aspects of the details of surgical interventions; because most operative procedures are performed in urgent circumstances in patients who often have a variety of conditions, it is not surprising that there is no best operation suited to every complication of ulcer.
尽管在药物治疗方面取得了进展，且疾病的自然史也发生了变化，但消化性溃疡患者偶尔仍会出现需要手术干预的并发症。临床外科医生必须根据本文讨论的信息，决定实施“选择性迷走神经切断术加胃窦切除术还是高选择性迷走神经切断术”。手术治疗的目标仍然是安全地纠正当前问题，避免围手术期的发病率和死亡率，并避免出现致残的术后副作用。本文探讨了手术干预细节的广泛方面；由于大多数手术都是在紧急情况下对往往患有多种病症的患者进行的，因此不存在适用于每种溃疡并发症的最佳手术也就不足为奇了。
