Deredzhian Kh
Khirurgiia (Sofiia). 1989;42(2):1-7.
Experience is recorded with 893 operations of duodenal ulcer for a period of 15 years. Of these, 872 patients (97.6 per cent) were operated as nonemergency planned cases, 48 of them subjected during a period of 7 years to proximal selective vagotomy in 3 variants. During the postoperative period one patient died of fatty pulmonary embolism. During the early postoperative period in 4 patients developed bronchopneumonia (8.3 per cent), in 3 transient cardiospasm (6.2 per cent) successfully controlled without surgical intervention. According to Visick's classification, excellent and very good postoperative results were recorded in 41 patients (87.2 per cent). Recurrent ulcer was demonstrated in 3 patients (6.4 per cent); only one of them required operative treatment--antrumectomy with revagotomy. It is pointed out that postoperative pH-metry of the stomach is not a pathognomonic sign, but may be criterion for a potentially possible recurrence. Continuous control is needed, since the majority of recurrent ulcers are not manifested by characteristic clinical symptoms.
记录了15年间893例十二指肠溃疡手术的经验。其中,872例患者(97.6%)为非急诊计划性手术病例,其中48例在7年期间接受了3种术式的近端选择性迷走神经切断术。术后有1例患者死于脂肪性肺栓塞。术后早期,4例患者发生支气管肺炎(8.3%),3例发生短暂性贲门痉挛(6.2%),未经手术干预成功控制。根据维西克分类法,41例患者(87.2%)术后结果为优秀和良好。3例患者(6.4%)出现复发性溃疡;其中只有1例需要手术治疗——胃窦切除术加迷走神经再切断术。指出术后胃pH值测定不是一个具有诊断意义的体征,但可能是潜在复发的一个标准。需要持续监测,因为大多数复发性溃疡没有特征性的临床症状。