Hellerer O, Rath H, Falter E, Holle F
Langenbecks Arch Chir. 1982;356(3):159-66. doi: 10.1007/BF01261753.
Using rats in a standardized animal experiment, the extent of duodenogastric reflux was studied eight months postoperatively following SPV with and without pyloroplasty. The reflux was determined by enzymatically testing the concentration of bile acid secretion withdrawn from the stomach intraoperatively. Serving as comparison were laparotomies, simple pyloroplasties, and the obligatory reflux models: resection after BII without enteroanastomosis. After SPV with and without pyloroplasty, the extent of duodenogastric reflux was less than in the control group. Specimens with simple pyloroplasty displayed a significantly greater reflux. The BII group had fivefold higher reflux than the control group. Since pyloroplasty can be considered a drainage operation, there is no retention of food particles in the stomach of the rat following SPV--an occurrence expected after SPV without pyloroplasty. However, due to the retarded stomach motility, the thickened chyme tends to linger at the opening of the stomach, thus reducing the duodenogastric reflux. According to our investigations, an increased duodenogastric reflux following SPV with or without pyloroplasty does not induce changes in the mucosa of the stomach.
在一项标准化动物实验中,使用大鼠研究了在有或没有幽门成形术的情况下,迷走神经切断术(SPV)术后八个月十二指肠胃反流的程度。术中通过酶法检测从胃中抽取的胆汁酸分泌浓度来确定反流情况。作为对照的是剖腹手术、单纯幽门成形术以及强制性反流模型:毕Ⅱ式切除术后不进行肠吻合。在有或没有幽门成形术的SPV术后,十二指肠胃反流的程度低于对照组。单纯幽门成形术的标本显示反流明显更严重。毕Ⅱ式组的反流比对照组高五倍。由于幽门成形术可被视为一种引流手术,在SPV术后大鼠胃内不会残留食物颗粒——这在没有幽门成形术的SPV术后是预期会出现的情况。然而,由于胃动力迟缓,浓稠的食糜往往会在胃开口处停留,从而减少十二指肠胃反流。根据我们的研究,有或没有幽门成形术的SPV术后十二指肠胃反流增加并不会引起胃黏膜的变化。