Dahm K, Eichen R, Werner B, Kozuschek W
Chirurg. 1976 Sep;47(9):494-5.
This study examines the question of which type of gastroenteral anastomosis is predisposed to carcinoma of the gastric stump. Evaluation of operative or autopsy reports of 72 patients with carcinomas of the gastric stump following ulcer resection was undertaken. The interval after resection for ulcer was on the average 23 years. In 69 cases a Billroth II resection with retrocolic anastomosis (Polya type) had been performed; 7 patients had a Billroth II resection with enteroanastomosis (Braun's type); only 3 cases of Billroth I resection were found in the whole collective. From the results it may be concluded that carcinoma of the gastric stump develops predominantly in the remaining stomach following Billroth II resection with retrocolic anastomosis (without Braun's enteroanastomosis). When retrocolic anastomosis is performed, the duodenogastric reflux definitely passes through via atrophic gastritis to the development of a stump carcinoma. However, when Billroth I resection or Billroth II resection with enteroanastomosis is performed, the duodenogastric reflux is low or is quantitatively derived into the jejunum.
本研究探讨了哪种类型的胃肠吻合术易引发残胃癌的问题。对72例溃疡切除术后发生残胃癌患者的手术或尸检报告进行了评估。溃疡切除后的间隔时间平均为23年。69例患者行毕Ⅱ式结肠后吻合术（波利亚式）；7例患者行毕Ⅱ式小肠吻合术（布劳恩式）；在整个研究群体中仅发现3例毕Ⅰ式切除术。从结果可以得出结论，残胃癌主要发生在毕Ⅱ式结肠后吻合术（无布劳恩小肠吻合术）后的残胃。当进行结肠后吻合术时，十二指肠胃反流肯定会通过萎缩性胃炎发展为残胃癌。然而，当进行毕Ⅰ式切除术或毕Ⅱ式小肠吻合术时，十二指肠胃反流较低或定量进入空肠。
