Printen K J, Owensby M
Surgery. 1978 Oct;84(4):455-6.
Gastric bypass, a 90% gastric exclusion, has been used successfully for surgical treatment of morbid obesity since 1967. Early concern as to its ulcerogenic potential has not materialized, but the physiological activity of the excluded stomach has not been studied fully. To determine whether the excluded segment retained any vagal innervation, 25 patients underwent preoperative Hollander tests of their intact stomachs. The test was repeated after operation, after the patients had resumed normal oral intake. Postoperative specimens were collected from a gastrostomy placed in the excluded stomach at the time of the gastric bypass. Percentage changes in volume and total acid for both the intact and excluded stomachs followed the same pattern with insulin injection after 45 minutes at both testings, pH values were identical. These observations, which indicate vagal innervation of the excluded stomach, together with previously published histalog acid-response data and the observed marginal ulcer incidence of one per 193 years of patient follow-up, demonstrate that normal gastric physiology is maintained after bypass and confirm that it is not an ulcerogenic procedure.
胃旁路手术，即90%的胃排除术，自1967年以来已成功用于治疗病态肥胖症的手术治疗。早期对其致溃疡可能性的担忧并未成为现实，但被排除胃的生理活动尚未得到充分研究。为了确定被排除的胃段是否保留任何迷走神经支配，25名患者在术前对其完整的胃进行了霍兰德试验。术后，患者恢复正常口服摄入后再次进行该试验。术后标本取自胃旁路手术时放置在被排除胃中的胃造口术。在两次测试中，45分钟后注射胰岛素后，完整胃和被排除胃的体积和总酸百分比变化遵循相同模式，pH值相同。这些观察结果表明被排除胃有迷走神经支配，再加上先前发表的组胺酸反应数据以及观察到的每193年患者随访中有一例边缘性溃疡发生率，表明胃旁路术后正常胃生理得以维持，并证实该手术不是致溃疡手术。
