Hildebrandt J, Herrmann U
Chirurgische Klinik, Städtischen Kliniken Dortmund.
Zentralbl Chir. 1992;117(1):36-40.
SPV with and without pyloroplasty were compared in a randomized clinical study for uncomplicated chronic duodenal ulcer. Additional pyloroplasty according to Finney reduced recurrence rate nor after 5 years (7.9:7.9%) neither after 10 years (16.7:12.5%) in comparison to SPV without pyloroplasty. Functional postvagotomy-syndromes dumping and diarrhoea, which were increased until 5th postoperative year after SPV with pyloroplasty, decreased in both groups to a lower level. Cause of late recurrences and decrease of postvagotomy-syndromes was seen in the vegetative reinnervation of stomach. There was no decrease in the lactase-deficiency-syndrome after SPV. Clinical results did not reveal any significant differences between both groups. It was suggested, that SPV without pyloroplasty is the best adequate operation for uncomplicated chronic duodenal ulcer.
在一项针对单纯性慢性十二指肠溃疡的随机临床研究中,对实施了幽门成形术和未实施幽门成形术的迷走神经切断术(SPV)进行了比较。与未实施幽门成形术的SPV相比,根据芬尼法实施的额外幽门成形术在5年后(7.9%:7.9%)和10年后(16.7%:12.5%)均未降低复发率。实施了幽门成形术的SPV术后第5年之前增加的迷走神经切断术后功能性综合征倾倒和腹泻,在两组中均降至较低水平。晚期复发和迷走神经切断术后综合征减少的原因在于胃的自主神经再支配。SPV术后乳糖酶缺乏综合征没有减轻。临床结果显示两组之间没有任何显著差异。有人提出,未实施幽门成形术的SPV是治疗单纯性慢性十二指肠溃疡的最佳适当手术。