Rossi R L, Braasch J W, Cady B, Sedgwick C E
Am J Surg. 1981 Apr;141(4):482-6. doi: 10.1016/0002-9610(81)90144-6.
Parietal cell vagotomy can be accomplished with minimal morbidity and mortality. Symptoms and signs of delayed gastric emptying early after operation are common and occur more frequently in patients with preoperative gastric outlet obstruction than in those without, a difference that is statistically significant. These symptoms are generally mild and transient. Dumping and diarrhea were not problems in our series. In patients with preoperative gastric outlet obstruction, parietal cell vagotomy with pyloroduodenal dilatation achieved good or excellent results in 79 percent of patients; however, the possibility of a higher recurrence rate requires further evaluation and suggests caution and selectivity in the use of this procedure. The recurrence rate of 3 percent of these patients without gastric outlet obstruction and a very good or excellent clinical result in 91 percent of these patients appear acceptable and encourage us to continue to use parietal cell vagotomy as the procedure of choice in patients with intractable duodenal ulcer. Most patients with recurrent ulcer have been treated medically with success. Close long-term clinical follow-up studies will be required to assess better the success of this procedure.
壁细胞迷走神经切断术的并发症发病率和死亡率极低。术后早期胃排空延迟的症状和体征很常见，术前存在胃出口梗阻的患者比无梗阻患者更常出现，且差异具有统计学意义。这些症状通常较轻且为一过性。倾倒综合征和腹泻在我们的病例系列中并非问题。对于术前存在胃出口梗阻的患者，壁细胞迷走神经切断术联合幽门十二指肠扩张术在79%的患者中取得了良好或极佳的效果；然而，复发率可能更高，这需要进一步评估，并提示在应用该手术时应谨慎且有选择性。这些无胃出口梗阻患者的复发率为3%，91%的患者临床效果非常好或极佳，这似乎是可以接受的，并鼓励我们继续将壁细胞迷走神经切断术作为治疗顽固性十二指肠溃疡患者的首选术式。大多数复发性溃疡患者已通过药物治疗取得成功。需要进行密切的长期临床随访研究，以更好地评估该手术的成功率。
