Vaughan G D, Frazier O H, Graham D Y, Mattox K L, Petmecky F F, Jordan G L
Am J Surg. 1977 Dec;134(6):785-90. doi: 10.1016/0002-9610(77)90325-7.
Repair of severe duodenal injuries often constitutes a technical challenge, and a variety of special technics have been described. For the past seven years we have utilized temporary pyloric exclusion and gastrojejunostomy to produce "diverticulization" of the duodenum. This procedure was utilized in seventy-five patients selected from 175 consecutive patients presenting with duodenal trauma. The mortality was 19 per cent and the rate of fistula formation was 5 per cent in this series and 14 per cent and 2 per cent, respectively, in the overall series. Follow-up studies of gastric physiology and functional anatomy show no evidence of alteration of these parameters. We thus believe that patients presenting with severe duodenal trauma and often multiple devastating associated organ injuries can be adequately treated with this procedure with a significant decrease in mortality and with marked improvement of postoperative morbidity.
严重十二指肠损伤的修复常常构成一项技术挑战，并且已经描述了多种特殊技术。在过去七年中，我们采用了临时性幽门封闭和胃空肠吻合术来使十二指肠“憩室化”。该手术应用于从175例连续十二指肠创伤患者中挑选出的75例患者。在这个系列中死亡率为19%，瘘形成率为5%，而在整个系列中分别为14%和2%。对胃生理学和功能解剖学的随访研究表明这些参数没有改变的迹象。因此我们认为，伴有严重十二指肠创伤且常常合并多处严重相关器官损伤的患者可以通过该手术得到充分治疗，死亡率显著降低，术后发病率明显改善。
