Gebhardt C, Moschinski D, Usmiani J
Langenbecks Arch Chir. 1977 Apr 22;343(4):313-8. doi: 10.1007/BF01300578.
This is a report on 64 patients, who were operated on because of gastric ulcer situated near the cardia. We found the best results after the so-called step-like resection, which is preferable to selective vagotomy with excision of the ulcer and pyloroplasty because of the special conditions of the secretion of gastric juice in the case of high ulcers. Because of the danger of the development of a cancer in a B-II-stomach we prefer the B-I-anastomosis. For ulcers with stenosis of the esophagus a cardiofundectomy should be performed. Ulcers high on the greater curvature and in the fundus should be excised and a distal gastrectomy (B-I) should follow. The sole excision of the ulcer or the operation according to Kelling-Madlener are not recommended.
这是一份关于64例因贲门附近胃溃疡而接受手术患者的报告。我们发现所谓的阶梯式切除术后效果最佳，鉴于高位溃疡患者胃液分泌的特殊情况，这种方法比选择性迷走神经切断术加溃疡切除及幽门成形术更可取。由于B-II型胃有发生癌症的风险，我们更倾向于采用B-I型吻合术。对于伴有食管狭窄的溃疡，应施行贲门胃底切除术。胃大弯高位及胃底部的溃疡应予以切除，随后进行远端胃切除术（B-I型）。不建议单纯切除溃疡或采用凯林-马德内尔手术。
