Barner S, Waldmann D, Farthmann E H
Fortschr Med. 1984 Jul 12;102(25-26):692-6.
The worldwide introduction of H2-receptor antagonists has resulted in changes in the management of gastric and duodenal ulcers. Today surgery is reserved mainly for patients with problem ulcers or ulcer complications. In this decision a lower recurrency rate of operative treatment must be weighed against higher immediate risks of this form of therapy. The treatment of choice for duodenal ulcers is the selective proximal vagotomy (SPV) without drainage, for gastric ulcers the partial gastrectomy (Billroth I- or II-procedures) or SPV, depending on their localizations. Only the differentiated use of medical and surgical treatment modalities permits optimal ulcer therapy.
H2受体拮抗剂在全球范围内的应用导致了胃溃疡和十二指肠溃疡治疗方式的改变。如今，手术主要用于治疗有问题的溃疡或溃疡并发症患者。在做出这一决策时，必须权衡手术治疗较低的复发率与这种治疗方式较高的直接风险。十二指肠溃疡的首选治疗方法是无引流的选择性近端迷走神经切断术（SPV），胃溃疡则根据其位置选择部分胃切除术（毕罗Ⅰ式或Ⅱ式手术）或SPV。只有合理运用药物和手术治疗方式，才能实现溃疡的最佳治疗。
