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[消化性溃疡的外科治疗]

[Surgical treatment of peptic ulcer].

作者信息

Hurtado-Andrade Humberto

机构信息

Servicio de Cirugía General, Centro Médico Nacional 20 de Noviembre, ISSSTE, México, D.F.

出版信息

Rev Gastroenterol Mex. 2003 Apr-Jun;68(2):143-55.

Abstract

Despite a decreasing number of operations for ulcer, there are many patients who require definitive treatment. If an operation is required for duodenal ulcer, vagotomy of some type is part of the treatment, and in gastric ulcer resection with or without vagotomy is required. Extended proximal gastric vagotomy can be performed in the majority of patients, excluding those who are unstable or have severe concomitant diseases. In cases of urgent surgery for hemorrhage or perforation, the surgical procedure must be selected individually. Although the role of traditional operations is well established, there is increasing interest in laparoscopic approaches. However, because there is a diminishing of elective surgery for ulcer, it is unlikely that these new procedures may be evaluated as operations were evaluated in the past.

摘要

尽管溃疡手术的数量在减少,但仍有许多患者需要确定性治疗。如果十二指肠溃疡需要手术,某种类型的迷走神经切断术是治疗的一部分,而胃溃疡则需要进行胃切除术,可伴或不伴迷走神经切断术。除了那些病情不稳定或有严重合并症的患者外,大多数患者都可以进行扩大近端胃迷走神经切断术。在因出血或穿孔而进行紧急手术的情况下,必须根据个体情况选择手术方式。虽然传统手术的作用已得到充分确立,但人们对腹腔镜手术方法的兴趣与日俱增。然而,由于溃疡择期手术的数量在减少,这些新手术不太可能像过去评估手术那样得到评估。

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