Schramm H
Dtsch Z Verdau Stoffwechselkr. 1980;40(5):169-76.
It is reported about 79 repeated interventions because of an ulcer pepticum jejuni and its relapses. The high rate of relapses to about 30 percent even after repeated interventions requires a radical concept of the reduction of acid. If a subsequent resection is necessary vagotomy should always be carried through, if possible in form of a selective vagotomy, vagotomy alone in case of a not penetrating flat ulcer or small residue of the stomach. If the general somatic condition of the patient allows it, duodenal passage should be carried through by means of the jejunal interposition. The examinations of the preoperative secretion have their greatest value in finding extragastric acid stimulators or antrum residues left behind.
据报道,约有79例因空肠溃疡及其复发而进行的重复干预。即使经过重复干预,复发率仍高达约30%,这就需要一种彻底的减少胃酸的理念。如果随后需要进行切除术,应始终进行迷走神经切断术,如有可能,采用选择性迷走神经切断术;对于未穿透的扁平溃疡或胃小残端,可单独进行迷走神经切断术。如果患者的一般身体状况允许,应通过空肠间置术进行十二指肠通路重建。术前分泌功能检查对于发现胃外酸刺激物或残留的胃窦具有最大价值。