Bailey R W, Flowers J L, Graham S M, Zucker K A
Department of Surgery, University of Maryland, School of Medicine, Baltimore 21201.
Surg Laparosc Endosc. 1991 Mar;1(1):45-9.
Laparoscopic surgery offers distinct advantages to traditional surgery, including decreased hospitalization and recovery periods, decreased postoperative discomfort, and improved cosmesis. A feasible laparoscopic approach to the treatment of peptic ulcer disease might confer similar patient benefits. A modified highly selective vagotomy (in combination with cholecystectomy for symptomatic cholelithiasis) has been successfully completed under laparoscopic guidance in a patient with intractable ulcer disease. The patient was discharged on the second postoperative day, tolerating a regular diet. The patient's dyspeptic symptoms disappeared during the immediate postoperative period and further endoscopic evaluation revealed resolution of active ulcer disease. Although experience is still limited in the United States, initial clinical results from Europe would indicate that laparoscopic vagotomy is not only feasible but effective. With further experience, laparoscopic vagotomy may provide a viable alternative to the standard treatment of peptic ulcer disease.
腹腔镜手术相较于传统手术具有明显优势，包括缩短住院时间和康复期、减轻术后不适以及改善美观效果。一种可行的腹腔镜治疗消化性溃疡疾病的方法可能会给患者带来类似的益处。在一名患有顽固性溃疡疾病的患者身上，在腹腔镜引导下成功完成了改良高选择性迷走神经切断术（联合对有症状胆结石患者进行胆囊切除术）。患者术后第二天出院，能够耐受常规饮食。患者的消化不良症状在术后即刻消失，进一步的内镜检查显示活动性溃疡疾病已痊愈。尽管在美国这方面的经验仍然有限，但欧洲的初步临床结果表明，腹腔镜迷走神经切断术不仅可行而且有效。随着经验的积累，腹腔镜迷走神经切断术可能会为消化性溃疡疾病的标准治疗提供一种可行的替代方案。
