Kennedy T, Green R
Br J Surg. 1978 May;65(5):323-5. doi: 10.1002/bjs.1800650510.
Regurgitation of bile into the stomach after gastric surgery often causes severe and distressing symptoms, though the onset may be delayed for some years. We have used a Roux loop diversion as a secondary procedure for bile reflux in 36 patients, making the anastomosis from 18 to 40 cm below the stomach. There were no deaths and the clinical results were good in 20 of 27 patients followed up from 1 to 10 years. Vagotomy was omitted in 13 patients, 2 of whom subsequently developed jejunal ulceration. One patient developed an unexplained gastric ulcer and 2 operations failed because the loop was too short. The optimum length may well be 40 cm and vagotomy should be added in all cases. In 3 patients with associated dumping the upper 10 cm of the Roux loop was reversed.
胃手术后胆汁反流至胃内常引起严重且令人痛苦的症状，尽管发病可能会延迟数年。我们采用Roux袢转流术作为36例胆汁反流患者的二次手术方法，使吻合口位于胃下方18至40厘米处。无死亡病例，27例随访1至10年的患者中有20例临床效果良好。13例患者未行迷走神经切断术，其中2例随后发生空肠溃疡。1例患者发生不明原因的胃溃疡，2例手术失败是因为袢太短。最佳长度很可能为40厘米，所有病例均应加行迷走神经切断术。3例伴有倾倒综合征的患者将Roux袢的上10厘米翻转。
