Mannell A, Hinder R A, San-Garde B A
Br J Surg. 1984 Jun;71(6):438-41. doi: 10.1002/bjs.1800710611.
The clinical progress, histological state of the gastric mucosa, gastric emptying of a liquid meal and duodenogastric reflux were studied postoperatively in 15 patients with a vagotomized intrathoracic stomach without a drainage procedure. The intact though denervated pylorus did not impede the emptying of liquids. Bile reflux into the thoracic stomach in both the erect and supine positions was significantly greater than that measured in control subjects. While posture did not affect duodenogastric reflux in the normal adult, bile reflux across the denervated pylorus was significantly increased in the supine position. Chronic active gastritis was noted in 12 patients but could not be correlated with the degree of bile reflux. Nine patients had evidence of pulmonary aspiration and gastric food residue was a common finding at endoscopy. The vagotomized intrathoracic stomach may need a drainage procedure to facilitate solid emptying.
对15例未行引流术的胸内胃迷走神经切断术患者术后的临床进展、胃黏膜组织学状态、流食胃排空及十二指肠胃反流情况进行了研究。完整但已去神经支配的幽门并未妨碍液体排空。无论直立位还是仰卧位，胆汁反流至胸内胃的情况均显著高于对照组。虽然体位对正常成年人的十二指肠胃反流无影响，但仰卧位时经去神经支配的幽门的胆汁反流显著增加。12例患者出现慢性活动性胃炎，但与胆汁反流程度无关。9例患者有肺误吸证据，内镜检查时常见胃内食物残渣。胸内胃迷走神经切断术患者可能需要行引流术以促进固体排空。
