Serdev N
Khirurgiia (Sofiia). 1989;42(4):5-9.
Results are reported of the operative treatment of stress ulcers by a refined method of selective proximal vagotomy (SPV), selective vagotomy (SV) with distal resection (DR) completely preserving the blood supply to the stomach along the minor curvature. For the period 1981-1988 a total of 82 patients with severe hemorrhage from stress ulcers have been treated. Thirty two of them were operated. In 2 patients SPV was performed by a modification suggested by the author and in another 6--SV also by modified technique with antrectomy B I. All patients recovered, none of them died. The results were compared with those in classical resection (17 operations, 1 reoperation, 12 repeated hemorrhagic episodes, 14 lethal cases) and with ulcer suturing (7 operations, 2 reoperations, 2 repeated hemorrhagic episodes, 7 lethal cases). The methods of SPV and SV with DR are recommended by the author as methods of choice, as they are pathogenetically grounded: satisfactory anacidity is achieved and the perfusion capacity of the stomach is preserved.
报告了采用改良选择性近端迷走神经切断术(SPV)、选择性迷走神经切断术(SV)加远端切除术(DR)对应激性溃疡进行手术治疗的结果,该方法完全保留了胃小弯的血供。在1981年至1988年期间,共治疗了82例应激性溃疡严重出血的患者。其中32例接受了手术。2例患者采用了作者建议的改良方法进行SPV手术,另外6例采用改良技术行SV加BI型胃窦切除术。所有患者均康复,无死亡病例。将结果与经典切除术(17例手术,1例再次手术,12次反复出血,14例死亡)和溃疡缝合术(7例手术,2例再次手术,2次反复出血,7例死亡)的结果进行了比较。作者推荐SPV和SV加DR的方法作为首选方法,因为它们有病理生理学依据:能实现满意的无酸状态并保留胃的灌注能力。