Dubois F
Clinique Hartmann, 26 Boulevard Victor Hugo, 92200 Neuilly, France.
World J Surg. 2000 Mar;24(3):270-6. doi: 10.1007/s002689910044.
Although peptic gastroduodenal ulcers are rarely treated surgically today, when surgery is required a laparoscopic approach is possible with its well known advantages. The most widely used technique is vagotomy by various modalities. Training in laparoscopy requires good instrumentation to avoid complications. Vagotomy can be truncal and bilateral via laparoscopy or thoracoscopy, which is the easiest and quickest procedure; moreover, the sequelae are less important and less frequent, as has been reported. It can also be highly selective or mixed, such as the Taylor procedure; and large series have been reported with good results. Gastric resection is rarely used for peptic ulcers, although it is feasible laparoscopically; it requires a large experience. Long-term results of laparoscopic vagotomy are now available and have indicated the same results as are attained with open surgery.
尽管如今消化性胃十二指肠溃疡很少通过手术治疗，但在需要手术时，腹腔镜手术方法可行且具有众所周知的优势。最广泛使用的技术是通过各种方式进行迷走神经切断术。腹腔镜手术培训需要良好的器械以避免并发症。迷走神经切断术可通过腹腔镜或胸腔镜进行全干和双侧切断，这是最简单、最快的手术；此外，正如所报道的，其后遗症不那么严重且不那么频繁。它也可以是高度选择性的或混合性的，如泰勒手术；并且已有大量病例系列报道取得了良好效果。胃切除术很少用于消化性溃疡，尽管腹腔镜下可行；它需要丰富的经验。腹腔镜迷走神经切断术的长期结果现已可得，且显示与开放手术取得的结果相同。
