Nikolaev N O, Startsev A I, Grishin S G, Chekmasov I A
Klin Med (Mosk). 1989 Sep;67(9):74-8.
Out of 1364 patients operated on in the Central Research Institute for Gastroenterology for ulcer, 130 (9.53%) appeared to have giant gastroduodenal lesions. The latter were gastric in 59 patients (more than 3 cm in diameter), duodenal in 71 (more than 2 cm in diameter). Surgical treatment of the giant ulcers is a valid therapeutic measure in view of frequent complications, uneffective conservative treatment, common recurrences. Billroth I gastrectomy was performed in 2 patients. Billroth II gastrectomy in 110 with additional bilateral subdiaphragmatic or selective vagotomy in 8 cases, Roux' operation in 2 patients. Gastroenteroanastomosis was established in 16 cases of inflammatory infiltrate, disturbed gastric evacuation, no evidence of hemorrhage from the ulcer; in 15 cases of truncal bilateral subdiaphragmatic vagotomy. Lethality reached 3.07% (4 patients), which is a relatively low rate achieved due to appropriate preoperative preparation and early surgical intervention.
在中央胃肠病学研究所接受溃疡手术的1364例患者中，有130例（9.53%）出现巨大胃十二指肠病变。其中59例为胃部病变（直径超过3厘米），71例为十二指肠病变（直径超过2厘米）。鉴于巨大溃疡并发症频繁、保守治疗无效且复发常见，对其进行手术治疗是一种有效的治疗措施。2例患者施行毕罗一式胃切除术。110例患者施行毕罗二式胃切除术，其中8例加做双侧膈下或选择性迷走神经切断术，2例患者施行鲁氏手术。16例有炎症浸润、胃排空障碍且无溃疡出血迹象的患者以及15例施行双侧膈下迷走神经干切断术的患者进行了胃肠吻合术。死亡率为3.07%（4例患者），这是由于术前准备充分和早期手术干预而达到的相对较低的比率。
