Amdrup E, Parmeggiani A
Minerva Chir. 1977 Sep 15;32(17):1029-37.
Gastric resection or vagotomy plus drainage are not easy alternatives for the treatment of duodenal ulcer. More complications are met after resection, more relapses after vagotomy, whereas the postoperative sequelae are the same for both operations. Vagotomy of the parietal cells is designed to prevent all such sequelae by leaving the innervation of the antrum intact so that drainage can be omitted. Experience has so far shown that very few complications occur, whereas severe and slight dumping and diarrhoea are virtually eliminated. Gastric emptying times are slightly affected (a little longer for solids and a little quicker for fluids), but drainage in non-stenosing cases of duodenal ulcer is not necessary. The true average incidence of recurrences after this operation cannot yet be determined, since the results of the published series vary considerably. This may be due to the continuous progress being made in the development of the surgical technique. Random studies comparing this operation with other forms of duodenal management are urgently required. It is, of course, essential for surgeons practising the new operation must, as in the case of other delicate surgial procedures, to receive a proper training at specialised centres.
胃切除术或迷走神经切断术加引流术并非治疗十二指肠溃疡的简易替代方法。胃切除术后会出现更多并发症，迷走神经切断术后复发更多，而两种手术的术后后遗症相同。壁细胞迷走神经切断术旨在通过保留胃窦神经支配完整来预防所有此类后遗症，从而可省略引流。迄今为止的经验表明，很少出现并发症，而严重和轻微的倾倒综合征及腹泻实际上已消除。胃排空时间略有影响（固体排空稍长，液体排空稍快），但十二指肠溃疡非狭窄病例无需引流。由于已发表系列研究结果差异很大，该手术术后复发的真实平均发生率尚无法确定。这可能是由于手术技术不断发展进步所致。迫切需要进行将该手术与其他十二指肠治疗方式进行比较的随机研究。当然，实施新手术的外科医生必须像进行其他精细手术一样，在专业中心接受适当培训。
