Adami H O, Enander L K, Rydberg B
Acta Chir Scand. 1977;143(7-8):457-62.
168 patients with duodenal or prepyloric ulcer, treated with parietal cell vagotomy (PCV), were followed up one to four years after operation. 67% of the patients had more than 5 years' history of ulcer disease and in 44% preoperative bleeding or perforation could be confirmed. According to the modified Visick classification the clinical results were considered excellent or very good in 71%, with a marked tendency to better results for those surgeons with the greatest experience in performing parietal cell vagotomy. The result was considered unsatisfactory in 25 patients (15%) and this was in all cases due to reoperation and/or recurrent ulcer. There was no postoperative mortality and a low frequency of postoperative complications. Dumping was found in only one patient and mild diarrhoea in two. At follow-up, 16 patients (9.5%) had had a proven and 8 (4.5%) a suspected recurrent ulcer and 3 had gastric retention without recurrence. The recurrence rate was very high for those patients operated during the first year after the introduction of PCV, but then decreased significantly. 18 patients required reoperation. Antrectomy or truncal vagotomy with drainage is considered the method of choice for patients with an incomplete PCV and recurrent ulcer.
168例十二指肠或幽门管溃疡患者接受了壁细胞迷走神经切断术（PCV）治疗，并在术后1至4年进行了随访。67%的患者有超过5年的溃疡病史，44%的患者术前出血或穿孔得到证实。根据改良的Visick分类，71%的临床结果被认为优秀或非常好，对于那些在进行壁细胞迷走神经切断术方面经验最丰富的外科医生，有明显的更好结果的趋势。25例患者（15%）的结果被认为不满意，所有这些情况都是由于再次手术和/或复发性溃疡。没有术后死亡病例，术后并发症发生率较低。仅1例患者出现倾倒综合征，2例出现轻度腹泻。随访时，16例患者（9.5%）有经证实的复发性溃疡，8例（4.5%）有疑似复发性溃疡，3例有胃潴留但无复发。在引入PCV后的第一年接受手术的患者复发率非常高，但随后显著下降。18例患者需要再次手术。对于PCV不完全和复发性溃疡的患者，胃窦切除术或伴有引流的全胃迷走神经切断术被认为是首选方法。
