Siedek M, Lindecken K D, Birtel F J, Rubinger M, Ebener J
Langenbecks Arch Chir. 1984;362(1):61-8. doi: 10.1007/BF01263321.
43 patients with complicated gastric, duodenal or anastomotic ulcers resected according to Billroth II-Roux were controlled clinically, by endoscopy and X-ray. Little amounts of bile acid were found in only one case. Two groups with different pH-values were verified: 6 patients with pH from 1.2 to 2.2; three of them had recurrent ulcers. In the other group of the remaining 37 patients pH was higher than 5.5; there was only one recurrence in a patient with HPT. According to the Visick grading system results were good or excellent in 86%. The study shows that under conditions of no bile reflux and maintained vagal stimulation recurrence of ulcer is probable. In the acid ulcer type (Johnson II and III), duodenal ulcer and anastomotic ulcer supplementary vagotomy is recommendable.
对43例根据毕罗Ⅱ式-鲁氏法切除的复杂性胃、十二指肠或吻合口溃疡患者进行了临床、内镜及X线检查。仅1例发现少量胆汁酸。证实有两组不同pH值的患者：6例pH值为1.2至2.2，其中3例有复发性溃疡。其余37例患者的另一组pH值高于5.5，仅1例甲状旁腺功能亢进患者出现复发。根据维西克分级系统，86%的结果为良好或优秀。该研究表明，在无胆汁反流且迷走神经刺激得以维持的情况下，溃疡有可能复发。在酸溃疡型（约翰逊Ⅱ型和Ⅲ型）、十二指肠溃疡和吻合口溃疡中，推荐行补充迷走神经切断术。
