Eckhauser F E, Strodel W E, Knol J A, Guice K S
Department of Surgery, University of Michigan Medical Center, Ann Arbor.
Am Surg. 1988 Mar;54(3):172-7.
The first clinical application of pyloric occlusion with gastrojejunostomy (duodenal exclusion) for management of lateral duodenal fistulas was reported by Berg in 1907. More recently Berne et al. applied this procedure to treat patients with complex pancreaticoduodenal trauma and modified it to include antrectomy with Billroth II reconstruction and tube duodenostomy. Over time the indications for duodenal exclusion have gradually been expanded to include management of actual or anticipated duodenal fistulas arising from operative injury or as a complication of inflammatory or neoplastic diseases. Our recent success using duodenal exclusion and/or diverticularization to manage one patient with duodenal trauma and two patients with nontraumatic forms of duodenal injury resulting in lateral duodenal fistulas caused us to reevaluate the efficacy of this procedure and forms the basis for this report.
1907年，伯格报道了幽门闭塞加胃空肠吻合术（十二指肠旷置术）在治疗十二指肠侧瘘中的首次临床应用。最近，伯恩等人将此手术应用于治疗复杂胰十二指肠创伤患者，并对其进行了改良，包括毕Ⅱ式重建的胃窦切除术和十二指肠造瘘管术。随着时间的推移，十二指肠旷置术的适应证逐渐扩大，包括处理手术损伤或作为炎症或肿瘤性疾病并发症而实际发生或预期发生的十二指肠瘘。我们最近使用十二指肠旷置术和/或憩室化手术成功治疗了1例十二指肠创伤患者和2例非创伤性十二指肠损伤导致十二指肠侧瘘的患者，这促使我们重新评估该手术的疗效，并构成了本报告的基础。
