Rossetti M, Hitz P, von Aarburg R
Chirurgische Klinik, Kantonsspital Liestal.
Helv Chir Acta. 1990 Apr;56(6):935-8.
The consequences of mixed esophagitis due to acid-peptic as well as biliary-pancreatic reflux are widely known today, even though they are partly accompanied by physiopathologic speculations. Much seems to indicate that the biliary component causes most pathologic modifications in the esophagus as the peptic reflux alone, such as Barrett, secondary brachyesophagus, strictures and even malignancy. In advanced cases with functional failure of the upper and lower sphincter, as well as the development of serious perifocal fibrosis in the thoraco-abdominal region or, often, in the cases with a multifactorial pathology after anti-reflux surgery, standard operations of the cardia is no longer possible. For many years resections or interpositions were proposed despite their morbidity, lethality and quality of life. The distal gastrectomy in healthy tissue with a long-Roux-Y drainage has proved to be a successful procedure. We present a study of 43 cases with an interesting pathology, as well as indications and long-term results.
尽管酸-消化性反流以及胆胰反流所致的混合性食管炎后果部分伴随着生理病理推测，但如今已广为人知。许多情况似乎表明，胆汁成分在食管中引起的病理改变比单纯的消化性反流更多，如巴雷特食管、继发性短食管、狭窄甚至恶性肿瘤。在上下括约肌功能衰竭的晚期病例中，以及在胸腹部区域出现严重的灶周纤维化时，或者通常在抗反流手术后出现多因素病理的病例中，贲门的标准手术已不再可行。多年来，尽管有发病率、致死率和生活质量方面的问题，仍有人提出进行切除或间置手术。在健康组织中进行带长Roux-Y引流的远端胃切除术已被证明是一种成功的手术方法。我们展示了一项对43例具有有趣病理情况、适应证及长期结果的研究。
