Salikhov I A, Fedorov V V, Krasil'nikov D M, Knubovets S Ia, Minnegaliev M M, Mosikhin B B
Khirurgiia (Mosk). 1989 Oct(10):23-6.
The results of surgical treatment of 1,069 patients for gastric and duodenal ulcer were studied. Duodenal stump incompetence (DSI) developed in 25 patients (6.3%) after the Billroth II operation; the incompetence was manifested by three clinical forms: infiltrative, primary-fistular, and perforative-peritoneal. Each form of DSI calls for specific tactics of treatment. The perforative-peritoneal form is most dangerous; during its operative management active aspiration-perfusion drainage of the zone of the stump must be installed and the duodenum relieved of a load as much as possible. Drugs reducing pancreatic function, postural drainage, and a diet is included in the complex of therapeutic measures in DSI. The wide introduction of organ-preserving operations into surgical practice will make it possible to avoid this threatening complication.
对1069例胃和十二指肠溃疡患者的手术治疗结果进行了研究。在毕罗Ⅱ式手术后，25例患者（6.3%）发生了十二指肠残端闭锁不全（DSI）；该闭锁不全表现为三种临床形式：浸润性、原发性瘘管性和穿孔性腹膜炎性。每种DSI形式都需要特定的治疗策略。穿孔性腹膜炎性形式最为危险；在其手术处理过程中，必须对残端区域进行积极的吸引-灌注引流，并尽可能减轻十二指肠的负荷。降低胰腺功能的药物、体位引流和饮食被纳入DSI治疗措施的综合方案中。在外科实践中广泛采用保留器官的手术将有可能避免这种威胁性并发症。
