Thompson J C, Fender H R, Watson L C, Villar H V
Ann Surg. 1976 May;183(5):599-608. doi: 10.1097/00000658-197605000-00018.
We have measured serum gastrin and gastric acid secretion in 66 duodenal ulcer patients before and after vagotomy and pyloroplasty (V + P--15 patients), selective proximal vagotomy without drainage (SPV - D--11 patients), and with drainage (SPV + D--19 patients), and vagotomy, antrectomy, and either gastroduodenostomy (V + BI--15 patients) or gastrojejunostomy (V + BII--6 patients). Basal and peak postprandial gastrin levels were increased in postoperative V + P, SPV - D, and SPV + D patients. Basal and peak postprandial levels of gastrin were unchanged after V + BII, indicative of duodenal release of gastrin. Gastrin response to food was abolished in V + BII patients. Acid output was reliably reduced after all five operations; reduction was greatest in patients after antrectomy and least in patients after SPV. No beneficial results were found with drainage in SPV patients. Acid secretion increased with time in SPV patients, especially those with drainage.
我们测定了66例十二指肠溃疡患者在迷走神经切断术和幽门成形术（V + P，15例患者）、无引流的选择性近端迷走神经切断术（SPV - D，11例患者）、有引流的选择性近端迷走神经切断术（SPV + D，19例患者）以及迷走神经切断术、胃窦切除术和胃十二指肠吻合术（V + BI，15例患者）或胃空肠吻合术（V + BII，6例患者）前后的血清胃泌素和胃酸分泌情况。术后V + P、SPV - D和SPV + D患者的基础和餐后胃泌素峰值水平升高。V + BII术后胃泌素的基础和餐后峰值水平未改变，表明胃泌素由十二指肠释放。V + BII患者对食物的胃泌素反应消失。所有五种手术后胃酸分泌均可靠降低；胃窦切除术后患者降低最大，SPV术后患者降低最小。SPV患者引流未发现有益结果。SPV患者胃酸分泌随时间增加，尤其是有引流的患者。
