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[胃十二指肠溃疡行无反流胃切除及 Roux-en-Y 吻合术后的结果]

[Results following reflux-free stomach resection with Roux-en-Y anastomosis in gastroduodenal ulcer].

作者信息

Mättig H, Schneider G, Wiesenhaken U, Wohlgemuth B, Goerl R

出版信息

Zentralbl Chir. 1987;112(5):303-11.

PMID:3591048
Abstract

The ulcer risk of Billroth-II-Y-Roux anastomosis, following distal two-third to three-quarter gastrectomy for complicated duodenal ulcer, ventricular ulcer, and pepto-jejunal ulcer was checked in 29 of 31 patients after surgery. (One patient had died after the operation and one rejected follow-up check for absence of complaints.) The same group of 29 patients underwent postoperative clinical examinations 1.6 years later, with additional nucleomedical, endoscopico-bioptic, and histological tests applied to 27 and additional secretion analysis to twelve of them. Twenty-eight patients were rechecked by Visick grading, approximately 3.9 years, following surgery. All 29 or 28 patients were clinically found to be in keeping with Visick I and II (100 per cent). Nucleomedical and endoscopic examinations did not reveal reflux in any of the 27 patients thus tested, and no recurrent ulcer was endoscopically recorded. Three patients refused to undergo endoscopy for absence of complaints. The time span of postoperative follow-up checks was as short as 1.6 years on average (between ten months and 4.5 years). Only trend information could, therefore, be derived from the histomorphological findings regarding minor mucosal changes, as compared to conventional techniques of resection. Reflux-free Y-Roux repair may be recommended as a mucosa-productive technique without increased ulcer risk, provided that gastrectomy is performed about 2 cm to 4 cm distal to the cardia.

摘要

对31例因复杂性十二指肠溃疡、胃溃疡和胃空肠溃疡行远端三分之二至四分之三胃切除术后行Billroth-II-Y-Roux吻合术的患者中的29例进行了术后溃疡风险检查。(1例患者术后死亡,1例因无不适拒绝随访检查。)同一组29例患者在术后1.6年接受了临床检查,其中27例还接受了核医学、内镜活检和组织学检查,12例进行了额外的分泌分析。28例患者在术后约3.9年通过Visick分级进行复查。临床发现所有29例或28例患者均符合Visick I级和II级(100%)。核医学和内镜检查未在接受检查的27例患者中发现反流,内镜检查未记录到复发性溃疡。3例患者因无不适拒绝接受内镜检查。术后随访检查的平均时间跨度短至1.6年(10个月至4.5年)。因此,与传统切除技术相比,从关于微小黏膜变化的组织形态学发现中只能得出趋势性信息。如果在距贲门远端约2 cm至4 cm处进行胃切除术,无反流的Y-Roux修复术可作为一种不增加溃疡风险的黏膜生成技术推荐使用。

相似文献

1
[Results following reflux-free stomach resection with Roux-en-Y anastomosis in gastroduodenal ulcer].[胃十二指肠溃疡行无反流胃切除及 Roux-en-Y 吻合术后的结果]
Zentralbl Chir. 1987;112(5):303-11.
2
Latest results (12-21 years) of a prospective randomized study comparing Billroth II and Roux-en-Y anastomosis after a partial gastrectomy plus vagotomy in patients with duodenal ulcers.一项前瞻性随机研究的最新结果(随访12至21年),该研究比较了十二指肠溃疡患者行胃部分切除加迷走神经切断术后毕罗Ⅱ式吻合术和 Roux-en-Y 吻合术的疗效。
Ann Surg. 2009 Feb;249(2):189-94. doi: 10.1097/SLA.0b013e3181921aa1.
3
Short-term results of gastrectomy with Roux-en-Y or Billroth II anastomosis for peptic ulcer. A prospective comparative study.胃大部切除术采用Roux-en-Y吻合术或毕Ⅱ式吻合术治疗消化性溃疡的短期结果。一项前瞻性对照研究。
Hepatogastroenterology. 1992 Feb;39(1):22-6.
4
A comparative study of gastrectomy without vagotomy with either Roux-en-Y or Billroth II anastomosis in peptic ulcer.在消化性溃疡中,不进行迷走神经切断术的胃切除术与Roux-en-Y吻合术或毕罗Ⅱ式吻合术的比较研究。
Hepatogastroenterology. 1994 Jun;41(3):294-7.
5
Histological changes in the gastric stump mucosa and late clinical results after Billroth I, Billroth II and Roux-en-Y operations for peptic ulcer disease.胃溃疡疾病行毕Ⅰ式、毕Ⅱ式和Roux-en-Y手术术后胃残端黏膜的组织学变化及远期临床结果
Ann Chir Gynaecol. 1988;77(1):1-5.
6
[Endoscopic and histopathologic changes in the gastric mucosa in Billroth II gastrectomy and in Roux-en-Y].毕罗Ⅱ式胃切除术和 Roux-en-Y 胃空肠吻合术中胃黏膜的内镜及组织病理学变化
Arq Gastroenterol. 1987 Jul-Dec;24(3-4):164-70.
7
[Surgical treatment of duodenal and stomach ulcers with the VARY operation (bilateral truncal vagotomy + antrectomy + Roux-Y gastrojejunostomy)].采用VARY手术(双侧迷走神经干切断术+胃窦切除术+Roux-Y胃空肠吻合术)治疗十二指肠溃疡和胃溃疡
Zentralbl Chir. 1988;113(23):1520-4.
8
Endoscopic follow-up after resection for gastric or duodenal ulcer.胃或十二指肠溃疡切除术后的内镜随访。
Acta Chir Scand. 1986 Apr;152:289-95.
9
[Duodeno-gastric reflux and its consequences after resection of stomach by Billroth II and Roux methods].[毕Ⅱ式和Roux式胃切除术后的十二指肠-胃反流及其后果]
Khirurgiia (Mosk). 1998(4):9-12.
10
[Clinical study and gastroscopy of biliary gastritis following gastric resection and Roux-en-Y anastomosis].
Schweiz Med Wochenschr. 1987 Jul 18;117(29):1094-7.

引用本文的文献

1
Effect of partial gastrectomy with Billroth II or Roux-en-Y anastomosis on postprandial and cholecystokinin-stimulated gallbladder contraction and secretion of cholecystokinin and pancreatic polypeptide.毕罗Ⅱ式或 Roux-en-Y 吻合术的部分胃切除术对餐后及胆囊收缩素刺激的胆囊收缩以及胆囊收缩素和胰多肽分泌的影响
Dig Dis Sci. 1990 Sep;35(9):1066-72. doi: 10.1007/BF01537576.