Nylamo E
Department of Surgery, University Central Hospital, Turku, Finland.
Ann Chir Gynaecol. 1991;80(4):349-52.
In the Department of Surgery, University Central Hospital of Turku, 197 patients underwent parietal cell vagotomy (PCV) for duodenal or pyloric-prepyloric ulcer in the years 1973-79. During follow-up for 10-15 years, 14 patients had died (none related to ulcer disease) and nine were lost to follow-up leaving 174 patients for the study. There were 21 proven recurrences of ulcer (12%), 16 after original duodenal ulcer (10%) and five after pyloric or prepyloric ulcer (26%). Late symptoms occurred as follows: Dyspepsia 19%, heartburn 17%, oesophageal reflux 16%, vomiting 7%, epigastric fullness 12%, dumping 8% and diarrhoea 7%. One patient underwent Nissen fundoplication for severe heartburn and mild oesophagitis without improvement. According to the Visick classification the overall result was excellent or good in 68%; the failure rate was 18%.--
PCV was satisfactory when used for duodenal ulcer, but after pyloric or prepyloric ulcer the recurrence rate was probably too high to be acceptable.
在图尔库大学中心医院外科，1973年至1979年间，197例患者因十二指肠溃疡或幽门-幽门前溃疡接受了壁细胞迷走神经切断术（PCV）。在10至15年的随访期间，14例患者死亡（均与溃疡病无关），9例失访，剩余174例患者用于研究。有21例溃疡复发得到证实（12%），其中16例发生在原发性十二指肠溃疡后（10%），5例发生在幽门或幽门前溃疡后（26%）。晚期症状如下：消化不良19%，烧心17%，食管反流16%，呕吐7%，上腹部饱胀12%，倾倒综合征8%，腹泻7%。1例患者因严重烧心和轻度食管炎接受了nissen胃底折叠术，但无改善。根据Visick分类，总体结果为优秀或良好的占68%；失败率为18%。——
PCV用于十二指肠溃疡时效果令人满意，但用于幽门或幽门前溃疡时，复发率可能过高，难以接受。
