Trueman K R
Can Med Assoc J. 1970 May 23;102(10):1043-6.
The experience with various surgical procedures performed for duodenal ulcer at the Winnipeg Clinic between 1946 and 1966 has been analyzed. Operative mortality has been low and ulcer control has been provided in a large proportion of patients treated. Of 864 cases, 719 (83%) have been available for follow-up study.All procedures employed provided satisfactory ulcer control. The vagotomy-with-gastric-resection group, although small, showed no ulcer recurrence and good general results. This outcome justifies the consideration of antrectomy and vagotomy as the operation of choice, with other procedures as alternatives. The combined procedure represents a more technically involved operation and possibly is indicated only in cases where the symptoms, complications and very marked acid secretion suggest a strong possibility of ulcer recurrence. Concern that a patient's ulcer diathesis may return as time elapses after vagotomy has not been borne out by our experience.
对1946年至1966年间在温尼伯诊所针对十二指肠溃疡实施的各种外科手术经验进行了分析。手术死亡率较低,且在大部分接受治疗的患者中溃疡得到了控制。在864例病例中,719例(83%)可供进行随访研究。所采用的所有手术方法均能使溃疡得到令人满意的控制。迷走神经切断术加胃切除术组虽然病例数较少,但未出现溃疡复发,总体效果良好。这一结果证明将胃窦切除术和迷走神经切断术作为首选手术,其他手术方法作为替代方法是合理的。联合手术代表了一种技术上更为复杂的手术,可能仅适用于症状、并发症以及胃酸分泌非常明显提示溃疡复发可能性很大的病例。我们的经验并未证实人们所担心的迷走神经切断术后随着时间推移患者的溃疡素质可能会复发这一情况。