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[选择性胃迷走神经切断术加胃窦切除术后预防胃潴留的新附加手术]

[New additional operation in the prevention of gastric stasis after selective gastric vagotomy with antrectomy].

作者信息

Shiratori T, Kanaizumi T, Murata S, Morimoto Y, Nakatsuzi N, Ueda T, Kubo Y, Koya T, Tatsumi H, Matsui T

出版信息

Nihon Heikatsukin Gakkai Zasshi. 1986 Dec;22(6):503-8. doi: 10.1540/jsmr1965.22.503.

Abstract

The new additional operation for the prevention of the gastric stasis after the selective gastric vagotomy with antrectomy (SV + A) was performed. Our additional operative procedure was followed: After selective gastric vagotomy and antrectomy, gastroduodenostomy was anastomosed at acute angle with the longitudinalis of the stomach. Then, both lesser and greater omentum were incised outside of the gastric vessels. After these procedure, posterior wall sided to lesser curvature was fixed with the edge of the hepatogastric ligament and posterior wall sided to greater curvature was fixed with the retroperitoneum inferior to the pancreas by several sutures. The outcome of these treatments of the additional operation on SV + A enabled to shorten the duration of drainage of gastric juice, as well as smooth intake. By fluoroscopic examination one month after operation, gastric stasis was observed on SV + A due to the contrast medium stored in the ptotic corpus, whereas, in the case of SV + A with our additional operation, smooth gastric emptying was observed without any stasis of the contrast medium, because the corpus was placed upper from the anastomosis portion. In conclusion, our additional operation to SV + A was able to perform easy and safely, and was observed the effective prevention of gastric stasis.

摘要

进行了一项新的附加手术,用于预防选择性胃迷走神经切断术加胃窦切除术(SV + A)后的胃潴留。我们的附加手术步骤如下:在选择性胃迷走神经切断术和胃窦切除术后,胃十二指肠吻合术以锐角与胃的纵轴吻合。然后,在胃血管外侧切开小网膜和大网膜。在这些步骤之后,胃小弯侧的后壁用肝胃韧带的边缘固定,胃大弯侧的后壁通过几针缝合固定在胰腺下方的腹膜后。这些附加手术对SV + A的治疗结果能够缩短胃液引流的持续时间,并使摄入顺畅。术后1个月通过透视检查,由于造影剂储留在下垂的胃体中,SV + A出现胃潴留,而在进行了我们附加手术的SV + A病例中,观察到胃排空顺畅,没有造影剂潴留,因为胃体位于吻合口上方。总之,我们对SV + A的附加手术操作简便且安全,有效预防了胃潴留。

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