Delaney P
Br J Surg. 1978 Mar;65(3):157-60. doi: 10.1002/bjs.1800650305.
Highly selective vagotomy (HSV) is now an accepted form of surgery for uncomplicated duodenal ulcer. Highly selective vagotomy and dilatation has been successfully used in some cases of pyloric stenosis, but many would regard severe pyloric stenosis as a contraindication to this procedure. Eleven patients with severe pyloric stenosis, measured objectively at operation, have been treated by HSV and dilatation of the stenosis and reviewed for periods of up to 3 years. The clinical results, immediate and long term, were good in all cases. Barium studies and histopathological findings were slower to return to normal. With intensive preoperative preparation to restore the tone of the dilated gastric muscle and gentle, controlled dilatation of the stricture, HSV in these patients should be as satisfactory as in those patients with uncomplicated duodenal ulcer.
高选择性迷走神经切断术（HSV）目前是治疗单纯性十二指肠溃疡的一种公认的手术方式。高选择性迷走神经切断术联合扩张术已成功应用于某些幽门狭窄病例，但许多人认为严重的幽门狭窄是该手术的禁忌症。11例经手术客观测量为严重幽门狭窄的患者接受了高选择性迷走神经切断术及狭窄扩张术治疗，并进行了长达3年的随访。所有病例的近期和长期临床效果均良好。钡餐检查和组织病理学结果恢复正常的时间较慢。通过强化术前准备以恢复扩张的胃肌张力，并轻柔、可控地扩张狭窄部位，这些患者接受高选择性迷走神经切断术的效果应与单纯性十二指肠溃疡患者一样令人满意。
