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毕罗Ⅱ式与 Roux-Y 胃空肠吻合术的比较研究。胃残端黏膜

[A comparative study of Billroth II and Roux-Y gastrojejunostomy. The mucosa of the gastric stump].

作者信息

Di Vita G, Siragusa G, Scozia A S, Franco V, Aragona F, Di Pace G

机构信息

Cattedra di Applicazioni Tecnologiche in Chirurgia, Università degli Studi di Palermo.

出版信息

Minerva Chir. 1991 Mar 15;46(5):169-73.

PMID:2041607
Abstract

Thirty-five patients who had undergone gastric resection between two and five years earlier were included in the study. Digestive continuity had been achieved in 18 cases using the BII method, and in 17 using a Roux en Y loop. Vagotomy was not performed in any patient. All patients were assessed using endoscopy and multiple biopsies of the gastric mucous were taken. No postoperative peptic ulcers were observed. Mucous close to the stoma appeared to be hyperemic and edematous in 16 of the patients who underwent gastric resection using the BII method and in 5 of those in whom a Roux en Y loop was used. In BII patients, the histological analysis of endoscopic biopsies revealed mucous alterations in 94.4% of cases, and the most frequent finding was chronic atrophic gastritis; in the Roux en Y patients signs of inflammation were only observed in 58.8% of patients and in the majority of cases it was limited to superficial chronic gastritis.

摘要

35例在两至五年前接受过胃切除术的患者被纳入该研究。18例患者采用毕Ⅱ式(BII)方法实现了消化道连续性重建,17例采用了 Roux-en-Y 袢。所有患者均未行迷走神经切断术。所有患者均接受了内镜检查,并对胃黏膜进行了多次活检。未观察到术后消化性溃疡。在采用BII方法进行胃切除的16例患者以及采用Roux-en-Y袢的5例患者中,吻合口附近的黏膜似乎出现充血和水肿。在BII患者中,内镜活检的组织学分析显示,94.4%的病例存在黏膜改变,最常见的发现是慢性萎缩性胃炎;在Roux-en-Y患者中,仅58.8%的患者观察到炎症迹象,且在大多数病例中仅限于浅表性慢性胃炎。

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