Schweizer W, Blunschi T, Seiler C
Universitätsklinik für Viszerale und Transplantationschirurgie, Inselspital Bern.
Helv Chir Acta. 1994 Apr;60(4):665-9.
We clinically followed 53 patients after a mean time of 3 years for postgastrectomy symptoms concerning 10 criteria including the Visick grading, dumping after Sigstad, efferent and afferent loop-syndrome, bile reflux, regurgitation and life-quality judged by the patient and the examiner. In our study we included 15 patients after a Billroth I, 15 after Billroth II, 15 patients after a Roux-en-Y reconstruction and 8 patients with a Roux-en-Y reconstruction because of severe disturbance of life quality after a primary Billroth II operation. The Roux-en-Y reconstruction showed significantly better results when compared to Billroth I and especially Billroth II reconstruction (p < 0.05). These results compare well with reports in the literature, where generally only one or two criteria are examined. We conclude that partial gastrectomy with Roux-en-Y reconstruction should be the preferred method provided that the procedure is adequate for the pathology found.
我们对53例患者进行了临床随访，平均随访时间为3年，观察胃切除术后与10项标准相关的症状，包括维西克分级、西格斯塔德倾倒综合征、输出袢和输入袢综合征、胆汁反流、反流以及患者和检查者判断的生活质量。在我们的研究中，包括15例毕罗Ⅰ式术后患者、15例毕罗Ⅱ式术后患者、15例Roux-en-Y重建术后患者以及8例因初次毕罗Ⅱ式手术后生活质量严重受扰而进行Roux-en-Y重建的患者。与毕罗Ⅰ式尤其是毕罗Ⅱ式重建相比，Roux-en-Y重建显示出明显更好的结果（p < 0.05）。这些结果与文献报道相符，文献中通常只检查一两项标准。我们得出结论，只要该手术方法适合所发现的病理情况，Roux-en-Y重建的部分胃切除术应是首选方法。
