Jordan P H
Gastroenterology. 1982 Jul;83(1 Pt 2):179-83.
One hundred and nine patients with perforated duodenal ulcer were treated by operation between 1973 and 1980. The operations performed included simple closure in 37 patients, vagotomy and drainage or gastric resection in 12 patients, and proximal gastric vagotomy without drainage and with omental patch of the perforation in 60 patients. Patients who were treated by proximal gastric vagotomy have been observed for 1-8 yr and form the basis of this study. There was no operative mortality. One patient with a postoperative infection required secondary drainage and a second patient with intestinal obstruction required lysis of adhesions. There were no other important complications. Persistent mild dumping occurred in 1 patient. Diarrhea was not a complication for any patient. One patient developed a recurrent ulcer and underwent truncal vagotomy and pyloroplasty. All patients except the patient with a recurrent ulcer had a Visick grading or I or II. Proximal gastric vagotomy, omental patch of the ulcer, and no drainage procedure is the ideal operation for patients who are candidates for definitive treatment of a perforated duodenal ulcer.
1973年至1980年间，109例十二指肠溃疡穿孔患者接受了手术治疗。所施行的手术包括37例单纯缝合、12例迷走神经切断术加引流或胃切除术，以及60例近端胃迷走神经切断术（不做引流，并用网膜修补穿孔）。接受近端胃迷走神经切断术治疗的患者已被观察1至8年，本研究以此为基础。无手术死亡病例。1例术后感染患者需二次引流，另1例肠梗阻患者需松解粘连。无其他重要并发症。1例患者出现持续性轻度倾倒综合征。腹泻并非任何患者的并发症。1例患者发生复发性溃疡，接受了全胃迷走神经切断术和幽门成形术。除复发性溃疡患者外，所有患者的Visick分级均为I级或II级。对于适合接受十二指肠溃疡穿孔确定性治疗的患者，近端胃迷走神经切断术、溃疡网膜修补术且不做引流是理想的手术方式。
