文摘

连续23十二指肠溃疡并发幽门狭窄患者受到的保健医生被高选择性迷走神经切断术治疗(HSV)结合数字扩张狭窄的胃切开术。使用任何形式的排水过程。因此,窦的“磨”和幽门sphineter完好无损。由于幽门狭窄通常远而不是真正幽门扩张不损害幽门环,虽然它有时可能导致的第一部分十二指肠穿孔。这些患者的后续进展比较类似的,连续的一系列23幽门狭窄患者治疗的躯干的迷走神经切断术和排水过程由其他外科医生在同一手术单位。随访4个月到5年。临床评估进行了“盲目”的方式在一个特殊的胃后续诊所。没有证据表明复发性溃疡在两组患者被发现。从每组两个病人随后来到救援再次手术的胃停滞。二十二岁的23例(96%)曾经历了HSV +扩张最终取得了优秀的临床结果(Visick等级(1 + 2),wheras只有17岁的23个患者(74%)曾经历了树干的迷走神经切断术与排水取得了这样的结果。 The main clinical difference between the two groups was that side effects such as diarrhoea and abdominal pain or discomfort were more common after vagotomy with drainage than after HSV. These results bear witness to the remarkable propulsive powers of the gastric antrum after HSV, which were evidently sufficient to overcome any tendency to re-stenosis in more than 90% of patients. The 9% incidence of failure due to re-stenosis could perhaps be avoided if a small duodenoplasty were performed instead of simple digital dilatation. The results support the hypothesis that damage to the antral mill and pyloric sphincter can be avoided in the course of operations for "pyloric" stenosis secondary to duodenal ulceration. Avoidance of the drainage procedure is of benefit to the patient, just as it is in patients who have duodenal ulceration without stenosis.