保留幽门的十二指肠空肠吻合术治疗十二指肠憩室

PYLORUS-PRESERVING DUODENOJEJUNOSTOMY IN THE TREATMENT OF DUODENAL DIVERTICULUM

保留幽门的十二指肠空肠吻合术(PPDJ)用作治疗十二指肠憩室5例,均无手术后的胃排空延迟。随访4～48月,平均27.80月,术前症状消失,体重增加了。胃镜检查显示幽门功能正常,无吻合口溃疡。PPDJ是十二指肠憩室治疗中转流手术之一种,但它优于胃大部切除术,且手术操作简单,并发症少。凡具有十二指肠憩室手术治疗指征,但不宜行憩室切除,或憩室切除术后复发。

Pylorus-preserving duodenojejunostomy (PPDJ) has been used in treating duodenal diverticulum in five patients. Gastric emptying postoperatively was delayed in none of these patients. The follow up period was 4 to 48 months, average 27.80 months. Preoperative symptoms disappeared and weight was regained. Gastroscop-ic examination showed a normal pyloric function, and no ulcer at the anastomosis site were found. This approach is one of the dfversfng procedures in the treatment of duodenal diverticuulm, however, it is better than the gastrectomy with simplified operative procedure, fewer complications and less long-term morbidity. PPDJ is recomended for patients with the following 3 indications. ( 1 ) patients who need operative treatment of the duodenal diverticulum but the expection of the diverticulum is inaccesible. (2) Patients who have a reoccurcnce after the removal of the duodenal diverticulum. And (3) Patients who have no history of gastric or duodenal ulcer