Büchler M, Beger H G
Abteilung für Allgemeine Chirurgie der Universität Ulm.
Z Gastroenterol. 1987 Aug;25 Suppl 3:188-93.
In gastric ulcer disease the operative procedure of choice is still partial gastrectomy, mostly carried out as Billroth I reconstruction with preservation of the duodenal passage. Indications for gastric resection are as follows: suspicion of malignancy, non-healing ulcers under conservative therapy, recurrent ulcer following conservative treatment, multiple and giant ulcers and ulcer complications like penetration, perforation, or bleeding. In duodenal ulcer gastric resection represents the exception. The routine operation is selective proximal vagotomy. The indication for partial gastrectomy in duodenal ulcer disease is: Recurrent ulcer after selective vagotomy (refractory to drugs), gastrin cell hyperplasia (hyper-function) and in rare cases of technical problems during surgery.
在胃溃疡疾病中,首选的手术方式仍然是胃部分切除术,大多采用毕罗一式重建术以保留十二指肠通路。胃切除的指征如下:怀疑有恶性病变、保守治疗下不愈合的溃疡、保守治疗后复发性溃疡、多发性和巨大溃疡以及溃疡并发症,如穿透、穿孔或出血。在十二指肠溃疡中,胃切除术是例外情况。常规手术是选择性近端迷走神经切断术。十二指肠溃疡疾病中行胃部分切除术的指征是:选择性迷走神经切断术后复发性溃疡(药物治疗无效)、胃泌素细胞增生(功能亢进)以及手术中罕见的技术问题。