[胃切除术后的反流及反流预防]

[Reflux and prevention of reflux in the resected stomach].

Schumpelick V, Begemann F, Grossner D, Schwoy M, Garbrecht A

Chir Forum Exp Klin Forsch. 1978(1978):7-12.

Abstract

After gastrectomy or vogotomy with pyloroplasty the reflux of bile acids and lysolecithin increased. 2. The highest values of reflux were observed in the retrocolic (short loop) B-II anastomosis. The different types of B-I antrectomy and the antecolic B-II with Braun's enterostomy have each the same reflux, which is significantly lower than the retrocolic B-II. Even these types of gastrectomy have 6 - 10-fold elevated reflux values compared to the controls. After vagotomy with pyloroplasty the reflux was reduced to two or three times normal. After selective proximal vagotomy without pyloroplasty no reflux was observed. 3. After an isoperistaltic jejunal transportation, the reflux was reduced, the reduction depending on the length of the transposed segment. The same result was obtained with a ROUX-en-Y-gastro-enterostomy. 4. After hemigastrectomy and isoperistaltic transposition of 25 cm of jejunum, more reflux could be observed under experimental and clinical conditions.

摘要

胃切除或迷走神经切断加幽门成形术后，胆汁酸和溶血卵磷脂的反流增加。2. 结肠后（短袢）B-II吻合术的反流值最高。不同类型的B-I胃窦切除术以及带布朗氏肠吻合术的结肠前B-II术式的反流情况相同，且均显著低于结肠后B-II术式。即便这些胃切除术式的反流值相较于对照组也升高了6至10倍。迷走神经切断加幽门成形术后，反流降至正常的两至三倍。选择性近端迷走神经切断术且未行幽门成形术时未观察到反流。3. 顺蠕动空肠转流术后，反流减少，减少程度取决于转流段的长度。Roux-en-Y胃肠吻合术也得到了相同结果。4. 半胃切除及25厘米空肠顺蠕动转位术后，在实验和临床条件下可观察到更多反流。