Schweizer W, Blunschi T, Gertsch P, Blumgart L H
Universitätsklinik für Viszerale und Transplantationschirurgie, Inselspital, Bern.
Schweiz Med Wochenschr. 1990 Apr 7;120(14):521-8.
53 patients who underwent gastric resection and reconstruction either by Roux-en-Y gastro-jejunostomy, Billroth I or Billroth II operation, were followed for an average of three years and compared for clinical status using the Visick grading system, dumping grading by the method of Sigstad, and careful clinical questioning regarding post-gastrectomy symptoms. Response to a standardized questionnaire and objective grading showed that our results for individual operations compared well with others reports. However, the Roux-en-Y reconstruction showed significantly better results when compared to Billroth I, and especially Billroth II, reconstruction. It is concluded that partial gastrectomy with Roux-en-Y reconstruction is the preferred approach, provided that, in the light of the pathology encountered at operation, the procedure is technically feasible and adequate.
53例行胃切除术并采用Roux-en-Y胃空肠吻合术、毕罗I式或毕罗II式手术进行重建的患者,平均随访三年,并使用Visick分级系统比较临床状况,采用Sigstad方法进行倾倒分级,并就胃切除术后症状进行仔细的临床询问。对标准化问卷的回答和客观分级表明,我们的个体手术结果与其他报告相比良好。然而,与毕罗I式,尤其是毕罗II式重建相比,Roux-en-Y重建显示出明显更好的结果。得出的结论是,只要根据手术中遇到的病理情况,该手术在技术上可行且充分,那么采用Roux-en-Y重建的部分胃切除术是首选方法。