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手术治疗的慢性胃溃疡:长期随访

The surgically treated chronic gastric ulcer: an extended followup.

作者信息

Davis Z, Verheyden C N, Van Heerden J A, Judd E S

出版信息

Ann Surg. 1977 Feb;185(2):205-9. doi: 10.1097/00000658-197702000-00012.

Abstract

Since the overall results of the medical management of chronic gastric ulcer are discouraging, the records of 595 patients with chronic gastric ulcers who underwent surgical treatment at the Mayo Clinic from 1961 through 1965 were reviewed. Gastric and duodenal ulcer (or scar) occurred together in 18%. Partial gastric resection was the predominant surgical procedure employed. There was an uneventful postoperative course in 83.2% of patients. Early complications occurred in 16.8%, death in 1%, and early reoperation in 3.4% of patients. Followup extended from 1 to 14 years. Late complications occurred in 31.1% of patients. The overall results, graded according to a modified Visik classification, were excellent in 31.9%, good in 48.4% and unsatisfactory in 8.1%. In patients undergoing partial gastrectomy for "channel ulcers", the incidence of reo 1% recurrence rate for ulcers elsewhere in the stomach, with or without truncal vagotomy. For the majority of gastric ulcers, partial gastric resection, with or without vagotomy, remains theoretically advantageous and clinically proven.

摘要

由于慢性胃溃疡内科治疗的总体结果令人沮丧,我们回顾了1961年至1965年在梅奥诊所接受手术治疗的595例慢性胃溃疡患者的记录。胃和十二指肠溃疡(或瘢痕)同时存在的占18%。主要采用的外科手术是胃部分切除术。83.2%的患者术后病程平稳。16.8%的患者出现早期并发症,1%的患者死亡,3.4%的患者需要早期再次手术。随访时间为1至14年。31.1%的患者出现晚期并发症。根据改良的维西克分类法分级,总体结果为:优31.9%,良48.4%,差8.1%。在因“通道溃疡”接受胃部分切除术的患者中,无论是否行迷走神经干切断术,胃其他部位溃疡的复发率为1%。对于大多数胃溃疡来说,无论是否行迷走神经切断术,胃部分切除术在理论上仍然具有优势且已得到临床验证。

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