Mouiel J, Katkhouda N
Department of Digestive Surgery, University of Nice, Sophia Antipolis, Saint-Roch Hospital, France.
World J Surg. 1993 Jan-Feb;17(1):34-9. doi: 10.1007/BF01655702.
Two laparoscopic procedures for treatment of chronic duodenal ulcer are described: bilateral truncal vagotomy with balloon pyloric dilatation and posterior truncal vagotomy with anterior lesser curve seromyotomy. The first procedure is simple to perform and easily reproducible, but the latter is preferred because it respects the physiology of the stomach. Thirty-six patients were operated on over a period of 18 months with good results comparable to those with open surgery. The indications for surgery were intractable chronic duodenal ulcers resistant to optimal medical therapy. There was no perioperative morbidity or mortality, and recurrent ulcers have not been demonstrated during early postoperative follow-up. The proper role of laparoscopic surgery in the arsenal of treatment of duodenal ulcers is unclear. The method of laparoscopic vagotomy requires rigorous experimental evaluation in specialized centers before widespread clinical application. Future multicentric prospective studies with long-term follow-up are necessary to assess the results of this innovative therapy of acid-peptic disease.
双侧迷走神经干切断术加气囊幽门扩张术和后迷走神经干切断术加前小弯浆膜切开术。第一种手术操作简单且易于重复，但后一种手术更受青睐，因为它尊重胃的生理功能。在18个月的时间里，对36例患者进行了手术，效果良好，与开放手术相当。手术适应症为对最佳药物治疗无效的顽固性慢性十二指肠溃疡。围手术期无发病率或死亡率，术后早期随访期间未发现复发性溃疡。腹腔镜手术在十二指肠溃疡治疗手段中的恰当作用尚不清楚。在广泛临床应用之前，腹腔镜迷走神经切断术的方法需要在专业中心进行严格的实验评估。未来需要进行多中心前瞻性长期随访研究，以评估这种治疗酸相关性疾病的创新疗法的效果。
