Sakhri J, Sabri Y, Skandrani K, Beltaifa D
Service de Chirurgie Générale et Digestive, CHU Farhat Hached, Sousse, Tunisie.
Tunis Med. 2000 Aug-Sep;78(8-9):494-8.
Final surgical treatment of perforated duodenal ulcer is not admitted by all authors. The aim of this study is to evaluate final treatment of perforated duodenal ulcer among 110 patients. 74.5% were aged less than 41 years. 107 patients underwent surgery. Treatment was based on: truncal vagotomy with pyloroplasty (99 cases), truncal vagotomy with closure of duodenal perforation and gastroentero-anastomosis (5 cases), truncal vagotomy with antrectomy (1 case) and simple closure of the duodenal perforation (2 cases). Mortality of truncal vagotomy with pyloroplasty was about 1%. According to the visick evaluation, clinical results were good in 95.3% cases without recurrent ulcer with a mean follow up of 4 years. According to our results truncal vagotomy with pyloroplasty seems to be a safe procedure in the management of perforated duodenal ulcer and more over gives good long-term results in control of peptic disease.
并非所有作者都认可十二指肠溃疡穿孔的最终手术治疗方法。本研究的目的是评估110例十二指肠溃疡穿孔患者的最终治疗情况。74.5%的患者年龄小于41岁。107例患者接受了手术。治疗方法包括:胃迷走神经干切断术加幽门成形术(99例)、胃迷走神经干切断术加十二指肠穿孔闭合术和胃肠吻合术(5例)、胃迷走神经干切断术加胃窦切除术(1例)以及单纯十二指肠穿孔闭合术(2例)。胃迷走神经干切断术加幽门成形术的死亡率约为1%。根据Visick评估,在平均随访4年且无复发性溃疡的病例中,95.3%的临床效果良好。根据我们的结果,胃迷走神经干切断术加幽门成形术在十二指肠溃疡穿孔的治疗中似乎是一种安全的手术方法,而且在控制消化性疾病方面能取得良好的长期效果。