Arlt G, Peiper C, Winkeltau G, Schumpelick V
Chirurgische Klinik, Medizinischen Fakultät der RWTH Aachen.
Langenbecks Arch Chir. 1993;378(6):341-4. doi: 10.1007/BF01876437.
The outcome of Billroth I hemigastrectomy for complicated recurrent ulcers after proximal selective vagotomy (PSV) for duodenal ulcer was analyzed in a retrospective study of 15 patients followed up for 15-81 months (mean 3.8 years) postoperatively. Bleeding was reported in 4, stenosis in 5, penetration in 3, perforation in 1 and refractory ulcer in 2 cases. None of the patients died during revision surgery, and none developed ulcer recurrence. In 4 patients complications were seen, including bleeding requiring relaparotomy (1) and subhepatic hematoma (3). In 12 patients (80%) a good or excellent result (Visick I/II) was seen at follow-up. Reasons for Visick III or Visick IV classification were reflux esophagitis grades I and II in 2 cases and refractory dyspeptic symptoms in 1 case. Distal gastric resection with a Billroth I anastomosis for complicated recurrent ulcer after PSV proved to involve only low morbidity and to effect reliable prophylaxis of ulcer recurrence in the long term.
在一项对15例患者进行的回顾性研究中，分析了十二指肠溃疡近端选择性迷走神经切断术（PSV）后行毕罗一世半胃切除术治疗复杂性复发性溃疡的结果。这些患者术后随访15 - 81个月（平均3.8年）。报告有4例出血、5例狭窄、3例穿透、1例穿孔和2例难治性溃疡。在翻修手术期间无患者死亡，且无患者出现溃疡复发。4例患者出现并发症，包括需要再次剖腹手术的出血（1例）和肝下血肿（3例）。12例患者（80%）在随访时结果良好或极佳（维西克I/II级）。维西克III级或IV级分类的原因是2例患者有I级和II级反流性食管炎，1例患者有难治性消化不良症状。PSV后行毕罗一世吻合的远端胃切除术治疗复杂性复发性溃疡，结果显示发病率低，且能长期有效预防溃疡复发。
