Lehmann L, Klein H D, Kern E
Langenbecks Arch Chir. 1976 Feb 10;340(3):179-90. doi: 10.1007/BF01254855.
The results of selective proximal vagotomy and pyloroplasty for duodenal and gastric ulcer in 464 patients over the last 5 years were evaluated in 438 cases. More than 75% of the patients were observed for 2 years after the operation. More than 25% were emergency cases, the incidence of intraoperative complications like splenic lesions or perforation of the esophagus was 3.2%. Postoperative complications like leakage of the pyloroplasty, peritonitis, hemorrhage from the pyloroplasty or disruption of the laparotomy closure occurred in 14,4%. The overall mortality was 4.6%, the elective mortality 1.6%. Recurrent ulcers were seen after 1/2-2 1/4 years with an overall rate of 3.2%. Over half of these cases required relaparotomy. In 5.3% relaparotomy had to be done for peritonitis, GI-bleeding, bleeding from the lesser curvature of the stomach, ileus or carcinoma. The Pentagastrin stimulated gastric secretion remained constantly reduced for more then 2 years in over 60%. Following the Visick-grading system the results were good in 61-65% of the patients and bad in 16-22% depending on the time of observation.
对过去5年中464例十二指肠和胃溃疡患者行选择性近端迷走神经切断术和幽门成形术的结果,在438例患者中进行了评估。超过75%的患者术后观察了2年。超过25%为急诊病例,术中并发症如脾脏损伤或食管穿孔的发生率为3.2%。术后并发症如幽门成形术漏液、腹膜炎、幽门成形术出血或剖腹手术切口裂开的发生率为14.4%。总死亡率为4.6%,择期手术死亡率为1.6%。术后1/2 - 2 1/4年出现复发性溃疡,总发生率为3.2%。其中超过一半的病例需要再次剖腹手术。5.3%的患者因腹膜炎、胃肠道出血、胃小弯出血、肠梗阻或癌症而不得不再次剖腹手术。超过60%的患者在术后2年多时间里,五肽胃泌素刺激的胃酸分泌持续减少。根据维西克分级系统,根据观察时间的不同,61 - 65%的患者结果良好,16 - 22%的患者结果较差。