胃大部切除术后吻合口排空障碍15例分析

THE ANASTOMOTIC SITE EMPTYING DISTURBANCE AFTER SUBTOTAL GASTRECTOMY

本文报道324例胃大部切除术后发生的吻合口排空障碍15例(4.6%),均经非手术疗法治愈。Billroth氏Ⅱ式与Ⅰ式吻合的发病情况相似,而结肠后吻合者(尤其是近端空肠对大弯者)较结肠前吻合者易于发生(P<0.05).作者认为吻合口水肿是产生排空障碍的主要因素;诊断明确后,应采用非手术疗法并避免作过多的检查.

Of the 324 subtotal gastrectomies performed from 1971 to 1980,there were 15 casesof postoperative emptying disturbance,an incidence of 4.5%.The incidences were similarbetween BillrothⅠand BillrothⅡtype anastomosis but it was more often in retro-colic(8.4%)than in anticolic(2%)and in Miekulicz operation(20%)than in Hoff-meister type gastrojejunostomy(P<0.05).This complication in all the 15 cases wascured in 3-21 days by conservative treatment,including gastric decompression,cortico-steroids and Chinese herb medicine.The authors hold that the main cause of emptyingdisturbance is edema at anastomotie site.