Kronborg O
Acta Chir Scand. 1975;141(7):657-63.
The clinical results of truncal vagotomy and drainage for duodenal ulcer in 500 patients are evaluated by a personal 6-8 year follow up. Pyloroplasty was used unless pyloric stenosis made a gastrojejunostomy necessary. Forty-three patients had recurrence (39 were reoperated) and gastric ulcer was seen in five. The rate of dumping was 24% (severe in 3%) and rate of daily-monthly diarrhoea 40% (severe in 8%). Neither dumping nor diarrhoea was related to histamine-activated gastric acid secretion ten days after vagotomy and insulin-activated acid secretion 3 to 4 years later. Dumping was related to epigastric fullness and diarrhoea. Recurrence was related to histamine-activated secretion before and 10 days after vagotomy and to insulin-activated secretion 10 days and 3-4 days after vagotomy. Minor changes were seen in weight- and laboratory-measurements. Anemia was not related to prophylactic intake of iron. Satisfactory results (Visick I-III) were seen in 80% of the patients. The figure may be increased to 86%, including results of operations for recurrence, gastric ulcer and other diseases occurring after the original vagotomy and drainage; even then, the results seem less satisfactory than those after other operations for duodenal ulcer.
通过个人6至8年的随访，对500例十二指肠溃疡患者行迷走神经干切断术加引流术的临床结果进行了评估。除非幽门狭窄需要行胃空肠吻合术，否则均采用幽门成形术。43例患者复发（39例行再次手术），5例出现胃溃疡。倾倒综合征发生率为24%（严重者占3%），每日至每月腹泻发生率为40%（严重者占8%）。倾倒综合征和腹泻均与迷走神经切断术后10天组胺激活的胃酸分泌以及3至4年后胰岛素激活的胃酸分泌无关。倾倒综合征与上腹部饱胀和腹泻有关。复发与迷走神经切断术前和术后10天组胺激活的分泌以及迷走神经切断术后10天和3至4天胰岛素激活的分泌有关。体重和实验室检查有轻微变化。贫血与预防性服用铁剂无关。80%的患者结果满意（Visick I-III级）。若将复发、胃溃疡及初次迷走神经切断术加引流术后出现的其他疾病的手术结果包括在内，这一数字可能增至86%；即便如此，其结果似乎仍不如十二指肠溃疡的其他手术效果令人满意。
