高选择性迷走神经切断术联合扩张术或十二指肠成形术。一种治疗梗阻性十二指肠溃疡的手术替代方案。
Highly selective vagotomy with dilatation or duodenoplasty. A surgical alternative for obstructing duodenal ulcer.
作者信息
Hooks V H, Bowden T A, Sisley J F, Mansberger A R
出版信息
Ann Surg. 1986 May;203(5):545-50. doi: 10.1097/00000658-198605000-00015.
Highly selective vagotomy (HSV) is an accepted choice for the treatment of uncomplicated duodenal ulcer. Its use in patients with gastric outlet obstruction, however, remains quite controversial. Since 1980, 69 patients have undergone HSV at the Medical College of Georgia Hospitals. Of these, 20 (29%) underwent either dilatation (14) or duodenoplasty (6) for accompanying outlet obstruction. The obstruction was graded as severe in 17 (85%) and moderate in three (15%). Follow-up evaluation has included Visick grading and endoscopy. There have been two deaths (38 and 54 months following surgery). Both patients were Visick I. Of the 18 patients available for review to date, 12 (67%) are Visick I and four (22%) are Visick II. There have been two failures (11%), discovered only by endoscopic follow-up in asymptomatic patients. No patients have required reoperation. HSV with dilatation or duodenoplasty is a reasonable surgical alternative for the treatment of obstructing duodenal ulcer disease.
高选择性迷走神经切断术（HSV）是治疗单纯性十二指肠溃疡的一种公认选择。然而，其在胃出口梗阻患者中的应用仍颇具争议。自1980年以来，69例患者在佐治亚医学院医院接受了HSV手术。其中，20例（29%）因伴有出口梗阻而接受了扩张术（14例）或十二指肠成形术（6例）。梗阻程度为重度的有17例（85%），中度的有3例（15%）。随访评估包括Visick分级和内镜检查。有2例死亡（分别在术后38个月和54个月）。这2例患者的Visick分级均为I级。在目前可供复查的18例患者中，12例（67%）的Visick分级为I级，4例（22%）为II级。有2例治疗失败（11%），仅在无症状患者的内镜随访中发现。没有患者需要再次手术。HSV联合扩张术或十二指肠成形术是治疗梗阻性十二指肠溃疡疾病的一种合理手术选择。
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