Amano K
Tohoku J Exp Med. 1981 Oct;135(2):165-78. doi: 10.1620/tjem.135.165.
The present study was conducted histologically to elucidate the influence of vagotomy on the gastric mucosa. Bioptical tissues were obtained from 10 control cases and from 26 cases of duodenal ulcer using an endoscope. Of the 26 cases of duodenal ulcer, 20 were subjected to truncal vagotomy with pyloroplasty and 6 to truncal vagotomy with hemigastrectomy. In the cases of duodenal ulcer, tissues were obtained at the preoperative stage, and at 1, 3, 6 and 12 months on the time-course basis after the operation. The parietal cells were counted in a unit area (0.0176 mm2) between the middle and lower 1/3 part of the fundic gland in H.-E. stained paraffin sections under microscopy. The length of the fundic gland was also measured. The results are summarized as follows: (1) There were a greater number of parietal cells and the length of the fundic gland was longer in the preoperative cases than in the controls. (2) Postoperative observations revealed that the number of parietal cells and the length of the fundic gland significantly decreased up to 3 months after the operation by both surgical techniques. Thereafter, the number of parietal cells and the length of the fundic gland significantly increased in the cases subjected to vagotomy with pyloroplasty. (3) The difference between the two surgical techniques was made clear when the mean values for the absolute number of parietal cells were compared at 3 months after the operation, the absolute number of parietal cells being smaller in hemigastrectomy than in pyloroplasty.
本研究采用组织学方法以阐明迷走神经切断术对胃黏膜的影响。使用内窥镜从10例对照病例和26例十二指肠溃疡病例获取活检组织。在26例十二指肠溃疡病例中，20例行迷走神经干切断术加幽门成形术，6例行迷走神经干切断术加半胃切除术。对于十二指肠溃疡病例，在术前阶段以及术后1、3、6和12个月按时间进程获取组织。在显微镜下，于苏木精-伊红（H.-E.）染色的石蜡切片中，对胃底腺中、下1/3交界处单位面积（0.0176平方毫米）内的壁细胞进行计数。同时测量胃底腺的长度。结果总结如下：（1）术前病例的壁细胞数量更多，胃底腺长度也比对照组更长。（2）术后观察发现，两种手术方式术后3个月内壁细胞数量和胃底腺长度均显著减少。此后，行迷走神经切断术加幽门成形术的病例中壁细胞数量和胃底腺长度显著增加。（3）比较术后3个月壁细胞绝对数的平均值时，两种手术方式的差异得以明确，半胃切除术后壁细胞的绝对数比幽门成形术的少。
