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选择性治疗良性胃溃疡时应选择迷走神经切断术还是胃切除术?

Vagotomy or gastrectomy for elective treatment of benign gastric ulceration?

作者信息

Greenall M J, Lehnert T

出版信息

Dig Dis Sci. 1985 Apr;30(4):353-61. doi: 10.1007/BF01403845.

Abstract

The results of elective gastrectomy and vagotomy with drainage for benign gastric ulcer are described in terms of operative mortality, recurrent ulceration, overall clinical results, and risk of malignancy. Although it has a slightly lower operative morbidity and mortality, the results of vagotomy with drainage are not sufficiently superior to abandon gastrectomy. Highly selective vagotomy, without drainage, provides good overall clinical results but has a high associated incidence of recurrent ulceration. Neither gastrectomy nor vagotomy with drainage have a distinct advantage in patients with combined gastroduodenal or prepyloric ulceration.

摘要

本文从手术死亡率、复发性溃疡、总体临床疗效以及恶性肿瘤风险等方面,描述了择期胃切除术、迷走神经切断术加引流术治疗良性胃溃疡的结果。尽管迷走神经切断术加引流术的手术发病率和死亡率略低,但其结果并不足以显著优于胃切除术,从而摒弃胃切除术。不做引流的高选择性迷走神经切断术总体临床疗效良好,但复发性溃疡的相关发生率较高。对于合并胃十二指肠溃疡或幽门管溃疡的患者,胃切除术和迷走神经切断术加引流术均无明显优势。

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