Khullar S K, DiSario J A
Division of Gastroenterology, University of Utah School of Medicine and Health Sciences Center, Salt Lake City, USA.
Gastrointest Endosc Clin N Am. 1996 Jul;6(3):585-603.
Acquired gastric outlet obstruction is more commonly owing to malignancy than ulcer disease. Endoscopy is the preferred method for diagnosis. Surgical palliation for malignant disease has poor results and high rates of morbidity and mortality. Initial experiences with endoscopic palliation with expandable metallic endoprostheses appear promising. Peptic ulcer-induced gastric outlet obstruction can be treated safely with endoscopic balloon dilation. About 65% of patients have sustained symptom relief, but many require more than one dilation session. Outcomes may be improved with effective ulcer therapy with acid reduction and eradication of H. pylori. Surgery is associated with significant morbidity and mortality and should be reserved for endoscopic treatment failures.
获得性胃出口梗阻更常见于恶性肿瘤而非溃疡病。内镜检查是首选的诊断方法。恶性疾病的手术姑息治疗效果不佳，发病率和死亡率较高。使用可扩张金属内支架进行内镜姑息治疗的初步经验似乎很有前景。消化性溃疡所致的胃出口梗阻可通过内镜球囊扩张安全治疗。约65%的患者症状得到持续缓解，但许多患者需要不止一次扩张治疗。通过有效的抑酸和根除幽门螺杆菌的溃疡治疗，可能会改善治疗效果。手术与显著的发病率和死亡率相关，应仅用于内镜治疗失败的情况。
