Stone H H, Mullins R J, Scovill W A
Ann Surg. 1985 Jun;201(6):684-9. doi: 10.1097/00000658-198506000-00003.
Three retrospective reviews documenting a lessened frequency of acute recurrent alcohol-induced pancreatitis following vagotomy, with or without gastrectomy or gastroenterostomy, prompted a prospective evaluation of truncal vagotomy with Bilroth II gastrectomy as a means of preventing such exacerbations. Randomization between operation and encouragement to abstain from alcohol in patients with a history of more than one, but less than ten, acute bouts of alcohol-induced pancreatitis was set by odd-even digits in the hospital number. Of 176 patients admitted with acute alcoholic pancreatitis during 23 months of study, 49 were excluded because of too few or too many prior attacks. Another 61 refused to enter the study. At least one (average 1.9) recurrence requiring hospitalization was noted in 49, or 80%, of these patients on follow-up for 2 to 26 months (average 14 months). Of the 66 who consented to participate, 33 were randomized not to undergo operation and had almost identical recurrence statistics (i.e., an average of 1.7 recurrences in 24, or 73%). By contrast, only two of 31, or six per cent, allocated to operation have experienced a recurrence (p less than 0.001). Two who had been randomized were excluded because of persisting active pancreatitis.
三项回顾性研究记录了迷走神经切断术（无论是否同时进行胃切除术或胃肠吻合术）后急性复发性酒精性胰腺炎发作频率降低的情况，这促使人们对毕罗Ⅱ式胃切除术联合迷走神经干切断术作为预防此类病情加重的一种方法进行前瞻性评估。对于有超过1次但少于10次急性酒精性胰腺炎发作史的患者，根据医院编号的奇偶数字进行手术与鼓励戒酒之间的随机分组。在23个月的研究期间，176例因急性酒精性胰腺炎入院的患者中，49例因既往发作次数过少或过多而被排除。另外61例拒绝参加研究。在对这些患者进行2至26个月（平均14个月）的随访中，49例（占80%）出现至少1次（平均1.9次）需要住院治疗的复发情况。在同意参与的66例患者中，33例被随机分配不接受手术，其复发统计数据几乎相同（即24例中有1.7次复发，占73%）。相比之下，在被分配接受手术的31例患者中，只有2例（占6%）出现复发（p<0.001）。有2例被随机分组的患者因持续性活动性胰腺炎被排除。
