DeSantis M, Devereux D F, Thompson D
Department of Surgery, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick 08903.
Am Surg. 1987 Dec;53(12):711-4.
Pyloric exclusion was first reported in 1977 as a temporary method of providing duodenal decompression in an attempt to protect the duodenum in the early postoperative period during the healing phase, followed by the return of normal gastrointestinal transit. It has been adopted by several trauma centers across the country as part of their armamentarium for managing moderate to severe duodenal injuries. Most series report using a polyglycolic acid (PGA) suture in performing the exclusion, anticipating a 3- to 4-week interval before pyloric patency is re-established. A comparison of polypropylene (PP), polyglycolic acid (PGA), and polydioxanone (PDS) sutures in the dog model suggests, however, that only PDS reliably accomplishes this goal. The low (approximately 5-10%) but finite incidence of fistula formation reported with pyloric exclusion using PGA may be improved by using PDS instead.
幽门旷置术于1977年首次被报道，作为一种提供十二指肠减压的临时方法，旨在在愈合阶段的术后早期保护十二指肠，随后恢复正常的胃肠运输。它已被全国多个创伤中心采用，作为其治疗中度至重度十二指肠损伤的手段之一。大多数系列报道在进行幽门旷置术时使用聚乙醇酸（PGA）缝线，预计在幽门通畅恢复前有3至4周的间隔期。然而，在犬模型中对聚丙烯（PP）、聚乙醇酸（PGA）和聚二氧六环酮（PDS）缝线的比较表明，只有PDS能可靠地实现这一目标。使用PGA进行幽门旷置术报道的瘘管形成发生率较低（约5-10%）但仍有一定比例，改用PDS可能会有所改善。
