Hai A A, Singh A, Mittal V K
Int Surg. 1986 Apr-Jun;71(2):87-90.
Out of a total of 300 consecutive cases of duodenal ulcer undergoing surgery, 51 patients were treated by truncal vagotomy and a closed pyloroduodenal digital dilatation. A peroperative assessment of the pyloroduodenal canal was carried out, and in patients with a mobile, supple duodenum showing minimal scarring a standard drainage procedure was not considered necessary. In these patients it was possible to perform a closed pyloroduodenal digital dilatation using the two thumbs to achieve an effective dilatation of 20-30 mm. Post-operative clinical evaluation (Modified Visick grading) and "special" barium meal revealed 86% of patients in Grade I and II at the end of two years (maximum follow-up 3.5 yrs.), with no evidence of lasting gastric stasis. The method is easy, safe and simple. It maintains the anatomical and physiological integrity of the pyloroduodenal ring thereby obviating the hazards of an "incontinent" stomach. Its main limitation appears to be its restricted selectivity and in the present series it could be carried out in about 17% of cases.
在连续接受手术治疗的300例十二指肠溃疡患者中，51例患者接受了迷走神经干切断术和幽门十二指肠闭合性手指扩张术。对幽门十二指肠管进行了术中评估，对于十二指肠活动度好、质地柔软且瘢痕形成轻微的患者，未考虑进行标准引流手术。在这些患者中，可以用双手拇指进行幽门十二指肠闭合性手指扩张，使幽门有效扩张20 - 30毫米。术后临床评估（改良Visick分级）和“特殊”钡餐检查显示，两年末（最长随访3.5年）86%的患者为I级和II级，无持久胃潴留的证据。该方法简便、安全。它保持了幽门十二指肠环的解剖和生理完整性，从而避免了“无节制”胃的危害。其主要局限性似乎在于其选择性有限，在本系列病例中，约17%的病例可以采用该方法。
