Ceneviva R, de Castro e Silva Júnior O, Castelfranchi P L, Módena J L, Santos R F
Br J Surg. 1986 Jun;73(6):427-30. doi: 10.1002/bjs.1800730604.
To assess the results of proximal gastric vagotomy (PGV) in the definitive treatment of perforated duodenal ulcers, a prospective study was carried out comparing PGV in association with omental patch suture (PGV + S) with the simple omental patch suture procedure (S). The PGV + S series consisted of 38 consecutive patients with perforated duodenal ulcer and the S series consisted of 38 survivors of a similar series of 41 consecutive patients. Surgical mortality was zero in the PGV + S series. The patients were followed up for 1 to 7 years. No cases of dumping or diarrhoea were observed. Thirty-three patients in the PGV + S series (87 per cent) were classified as Visick grade I and only two (5 per cent) as Visick grade IV. In contrast, 11 patients (29 per cent) were Visick grade I and 22 (58 per cent) were Visick grade IV in the S series. Recurrent ulcer was detected endoscopically in 58 per cent of the patients who had been treated with simple suture and in only 5 per cent after suture plus PGV. PGV is a safe operation with a negligible morbidity rate and with a significant rate of effective control of ulcer disease. Depending on the general condition of the patient and on the surgeon's skill, it appears preferable to treat not only the acute perforation but also the ulcer disease by PGV.
为评估近端胃迷走神经切断术（PGV）在十二指肠溃疡穿孔确定性治疗中的效果，开展了一项前瞻性研究，比较PGV联合网膜补片缝合术（PGV + S）与单纯网膜补片缝合术（S）。PGV + S组包括38例连续的十二指肠溃疡穿孔患者，S组包括来自41例连续患者的类似系列中的38例幸存者。PGV + S组的手术死亡率为零。对患者进行了1至7年的随访。未观察到倾倒或腹泻病例。PGV + S组中有33例患者（87%）被分类为Visick I级，只有2例（5%）为Visick IV级。相比之下，S组中有11例患者（29%）为Visick I级，22例（58%）为Visick IV级。在接受单纯缝合治疗的患者中，内镜检查发现复发性溃疡的比例为58%，而在缝合加PGV治疗后仅为5%。PGV是一种安全的手术，发病率可忽略不计，对溃疡病的有效控制率很高。根据患者的一般状况和外科医生的技术，似乎不仅应通过PGV治疗急性穿孔，还应治疗溃疡病。
