腹腔镜下迷走神经切断加溃疡穿孔粘堵治疗十二指肠溃疡穿孔38例报告

Laparoscopic truncal vagotomy combined with occlusive dressing therapy for the treatment of 38 cases with duodenal ulcer perforation

目的：探讨腹腔镜在溃疡穿孔治疗中的应用价值。方法：将明胶海绵卷成锥体检，尖端塞入穿孔，基底部稍高于浆膜面，均匀滴入生物蛋白胶1．0～1．5ml在明胶海绵栓及其周围，采用Hill术式，切断迷走神经后干和高选择性切断前干。结果：全部病例术后8～9d痊愈出院。全部随访复查胃镜检查渍疡面愈合情况，38例中36例溃疡面愈合，另2例给予内科药物治疗痊愈。结论：腹腔镜下行迷走神经切断术加溃疡穿孔粘堵术治疗十二指肠溃疡穿孔疗效可靠，创伤小，值得推广。

Objective： To discuss the clinical value of laparoscopy in treating duodenal ulcer perforation. Methods： 38 cases with duodenal ulcer perforation underwent laparoscopic truncal vagotomy （Hill＇s procedure） combined with occlusive dressing therapy. Results： All cases succeeded. The hospitalization was less than 7 days. Follow up gastroscopy revealed ulcer healing in 36 patients, the other two also healed with the help of medicine. Conclnsions： Treating duodenal ulcer perforation with laparoscopic truncal vagotomy combined with occlusive dressing therapy is an effective way. It has the characteristic of less pain and is worth popularizing.