Knight C D, Van Heerden J A, Kelly K A
Ann Surg. 1983 Jan;197(1):22-6.
Experience with proximal gastric vagotomy at the Mayo Clinic from 1973 to Mayo 1980 is reported. Among 298 patients who had proximal gastric vagotomy for chronic duodenal, pyloric channel, or prepyloric ulcers, a recurrent ulcer rate of 7% was present, with a mean follow-up of 49 months. Three recurrences developed in six patients who had proximal gastric vagotomy for gastric ulceration. In 40 patients, proximal gastric vagotomy was combined with gastrojejunostomy, pyloroplasty, or pyloric dilatation for obstructing ulcers. There was a 15% incidence of reoperation in the gastrojejunostomy group. All nine patients who had proximal gastric vagotomy for active or recent bleeding ulcers were dismissed from the hospital without further hemorrhage, and only one developed a recurrent ulcer. It is concluded that proximal gastric vagotomy remains an acceptable operation for chronic duodenal and pyloric ulcers, but its efficacy in gastric ulcers is unproved.
报告了1973年至1980年梅奥诊所近端胃迷走神经切断术的经验。在298例因慢性十二指肠溃疡、幽门管溃疡或幽门前溃疡接受近端胃迷走神经切断术的患者中，复发溃疡率为7%，平均随访49个月。6例因胃溃疡接受近端胃迷走神经切断术的患者中有3例复发。40例患者因梗阻性溃疡接受近端胃迷走神经切断术并联合胃空肠吻合术、幽门成形术或幽门扩张术。胃空肠吻合术组再次手术的发生率为15%。所有9例因活动性或近期出血性溃疡接受近端胃迷走神经切断术的患者均未再出血出院，只有1例发生复发性溃疡。结论是，近端胃迷走神经切断术仍是治疗慢性十二指肠溃疡和幽门溃疡的可接受手术，但对胃溃疡的疗效尚未得到证实。
