Ghidotti G, Balotta F, Lucani G, Santoro A
Minerva Chir. 1979 Nov 30;34(22):1547-54.
The treatment used in 122 patients suffering from perforation of gastroduodenal ulcer in free peritoneum is presented. 77 were subjected to straightforward suture of the perforation. Hemigastrectomy was carried out in 43 and in 2 superselective vagotomy associated with removal of the duodenal ulcer and duodenoplasty. Mortality in the series was 11.04% after suture but allowance must be made here for the serious condition of the patients who underwent this form of operation. Of the patients treated with straightforward perforation suture, 36.5% were reoperated for the reappearance of ulcerous symptomatology, while the remaining 63.7% were cured. On the basis of this experience, it is considered that superselective vagotomy associated or otherwise with pyloroplasty, and subtotal gastrectomy are indicated in patients in good general condition and in whom ulcer perforation symptomatology goes back less than 12 hours.
本文介绍了对122例游离腹膜十二指肠溃疡穿孔患者采用的治疗方法。77例行穿孔直接缝合术。43例行半胃切除术，2例行超选择性迷走神经切断术并切除十二指肠溃疡及十二指肠成形术。该系列病例中，缝合术后死亡率为11.04%，但必须考虑到接受这种手术方式的患者病情严重。在接受直接穿孔缝合术治疗的患者中，36.5%因溃疡症状复发而再次手术，其余63.7%治愈。基于这一经验，认为对于一般状况良好且溃疡穿孔症状出现时间少于12小时的患者，可采用超选择性迷走神经切断术联合或不联合幽门成形术以及胃次全切除术。
