Gorbunov V N, Sytnik A P, Korenev N N, Gordeev S A, Stoliarchuk E V, Urzhumtseva G A
Khirurgiia (Mosk). 1998(9):14-7.
Results of treatment of 1309 patients with perforated and bleeding pyloroduodenal ulcers for 20-years period have been analysed. Resection of the stomach performed in 85 cases resulted in high postoperative lethality which made up in bleeding ulcers 14.8%. Drainage operations of the stomach with excision or suturing of ulcer combined with bilateral truncal vagotomy was performed in 60 patients, postoperative lethality rate being 8.4%. 128 patients underwent selective proximal vagotomy together with pyloro- and duodenoplasty, lethality rate being 1.6%. Combined vagotomy (posterior truncal and anterior sero-muscular) with excision of ulcer, transversal pyloroplasty and duodenoplasty was carried out in 1036 patients (postoperative lethality--2.4%). Excellent and good functional results were achieved in 79.6% of the patients.
对1309例穿孔性和出血性幽门十二指肠溃疡患者20年的治疗结果进行了分析。85例行胃切除术的患者术后死亡率较高,出血性溃疡患者的术后死亡率为14.8%。60例患者行胃引流术,同时切除或缝合溃疡并加双侧迷走神经干切断术,术后死亡率为8.4%。128例患者行选择性近端迷走神经切断术并加幽门和十二指肠成形术,死亡率为1.6%。1036例患者行联合迷走神经切断术(迷走神经干后支和前浆肌层)并加溃疡切除术、横向幽门成形术和十二指肠成形术(术后死亡率为2.4%)。79.6%的患者获得了优良的功能效果。