Ross T M, Fazio V W, Farmer R G
Ann Surg. 1983 Apr;197(4):399-406. doi: 10.1097/00000658-198304000-00004.
To assess the long-term results of surgery for duodenal Crohn's disease, 11 patients, ten surgically treated, have been followed an average of 13.9 years to assess 1) the need for further treatment of duodenal disease; 2) the activity of Crohn's disease in other areas of the gastrointestinal tract; and 3) their functional status based on the Karnofsky Performance Scale (KPS). Follow-up indicates that seven patients have required a total of ten further operations directly related to duodenal Crohn's disease. The indications for subsequent operations were 1) marginal ulceration; 2) obstruction at or in one limb of the gastrojejunostomy due to recurrent jejunal Crohn's disease or stricturing at the gastrojejunostomy; and 3) duodenal fistula. Eight of these 11 patients also required surgery for Crohn's disease in other areas of the gastrointestinal tract. Despite a high reoperative rate for Crohn's disease in both the duodenum and other areas of the gastrointestinal tract, functional results, as tested by the KPS, can be satisfactory if appropriate reoperative surgery is done.
为评估十二指肠克罗恩病手术的长期效果，对11例患者（10例接受了手术治疗）进行了平均13.9年的随访，以评估：1）十二指肠疾病进一步治疗的必要性；2）胃肠道其他部位克罗恩病的活动情况；3）基于卡诺夫斯基表现量表（KPS）的功能状态。随访表明，7例患者因十二指肠克罗恩病共需要进行10次进一步手术。后续手术的指征为：1）边缘溃疡；2）由于复发性空肠克罗恩病或胃空肠吻合口狭窄导致胃空肠吻合口一处或其一个分支出现梗阻；3）十二指肠瘘。这11例患者中有8例还因胃肠道其他部位的克罗恩病需要手术。尽管十二指肠和胃肠道其他部位的克罗恩病再次手术率较高，但如果进行适当的再次手术，通过KPS测试的功能结果可能会令人满意。
