Meyer C, Bachellier-Billot C, Rohr S, De Manzini N, Leclercq A
Service de Chirurgie Générale et Digestive, CHU Hautepierre, Strasbourg.
J Chir (Paris). 1991 Mar;128(3):112-5.
The study turns about 68 cases of post ulcerous pyloric stenosis operated from 1970 to 1990, that means 8.5% of the duodenal ulcers (796 cases) operated during this period. The stenosis was entire or strangled in 27 cases (39.7%) with an important gastric dilatation in 34 cases (50%). The treatment has been composed of a gastroenterostomy (30 cases--44%), most of the time with a troncular vagotomy, of a pyloroplasty with vagotomy in 20 cases (29.5%) and of an inferior polar gastric resection in 18 cases (26.5%). The operative mortality was 2 cases (3%). The at distance-results (average follow-up of 7 years) show that 71% of the re-examined patients (45 cases) are classified Visick 1 or 2 and 9% visick 4. Ones concludes to the value of troncular vagotomy with gastroenterostomy which can be realised in all of the occasions and gives good functional results when the vagotomy with pyloroplasty seems to lie more frequently in state to uncertain functional results.
该研究涉及1970年至1990年间接受手术治疗的68例溃疡后幽门狭窄患者，占同期接受手术治疗的十二指肠溃疡患者（796例）的8.5%。27例（39.7%）狭窄为完全性或绞窄性，34例（50%）伴有明显胃扩张。治疗方法包括胃空肠吻合术（30例，占44%），多数情况下同时行迷走神经干切断术；幽门成形术加迷走神经切断术20例（29.5%）；胃下极切除术18例（26.5%）。手术死亡率为2例（3%）。远期结果（平均随访7年）显示，复查患者中71%（45例）的Visick分级为1级或2级，9%为Visick 4级。得出结论：迷走神经干切断术加胃空肠吻合术具有价值，在所有情况下均可实施，且当幽门成形术加迷走神经切断术的功能结果似乎更常不确定时，该术式能取得良好的功能效果。
