Houdelette P, Kunkel K, Moreau X, Dumotier J
Ann Chir. 1989;43(4):282-4.
Gastric ulcer, an uncommon complication of Nissen technique, is nevertheless reported in all series (between 1 and 5% of cases). The authors report a case occurring after a complete fundoplication associated with a longitudinal stapling of the cardia (Rignault's procedure) which resolved after reoperation and transformation into a posterior hemi-valve. The pathogenesis of post-Nissen gastric ulcer is discussed; the mechanical factor appears to be decisive in the subcardial site. Surgical revision according to various modalities is generally unavoidable.
胃溃疡是尼森手术罕见的并发症,但在所有病例系列中均有报道(占病例的1%至5%)。作者报告了1例在完全胃底折叠术联合贲门纵向吻合术(里尼奥手术)后发生的胃溃疡病例,该病例在再次手术并转变为后半瓣膜术后得到解决。本文讨论了尼森术后胃溃疡的发病机制;机械因素似乎在贲门下方部位起决定性作用。通常不可避免地需要根据各种方式进行手术修正。