Shalimov A A, Korotkiĭ V N, Teplyĭ V V, Mamedli Z Z
Vestn Khir Im I I Grek. 1986 Dec;137(12):26-30.
The character of the source and rate of bleeding were taken into consideration in determining the surgical tactics in 342 patients with cirrhosis of the liver complicated by gastro-esophageal bleedings and with high risk of their appearance. The operation of choice is thought to be arrest of the gastro-esophageal collateral blood flow. At high portal pressure or its considerable growing after the separating operation the latter should be associated with vascular anastomosis. When cirrhosis of the liver is associated with ulcer disease of the duodenum the separating operation should be added by selective proximal vagotomy, for ulcer disease of the stomach--by a parsimonious resection.
在确定342例肝硬化合并胃食管出血且有出血高风险患者的手术策略时,考虑了出血来源的特征和出血速度。认为首选的手术是阻断胃食管侧支血流。在门静脉高压或分流术后门静脉压力显著升高时,后者应与血管吻合术联合进行。当肝硬化合并十二指肠溃疡时,分流手术应加做选择性近端迷走神经切断术;当合并胃溃疡时,则应进行保守性切除术。