270例胃切除术后的内镜下观察及临床分析

Endoscopic Observation and Clinical Analysis of 270 Patient with Post-gastrectomy Complications.

了解胃切除术后主要并发症的成因及在内镜下的表现。方法：分析２７０例胃切除术后因上消化道症状而行胃镜检查的结果。结果：本组中反流性食管炎占５．１９％，Ｂａｒｒｅｔｔ食管１．４８％，食管癌１．１１％，吻合口炎１５．９３％，残胃炎２８．８９％，胃及吻合口溃疡２６．６７％，胃癌１１．８５％，正常胃粘膜２８．８９％，缝线残留者２７．４７％。结论：术后残胃的主要并发症为炎症、溃疡、肿瘤。手术方式及缝线的选择均对术后并发症有影响，胃镜摘除术后残留缝线可减少部分并发症。

To analyse the causes post-gastrectomy of complications by aid of endoscopy. Methods: 270 post-gastrectomy patients with symptoms of upper digestive tract were subjected to endoscopic examination, the clinico-pathological data were analyzed. Results: Of the 270 patients, 5.19% had reflux esophagitis, 1.48% with Barrett esophagus, 1.11% with esophageal cancer, 15.93% with anastomotic inflammation, 8.89% with cancer of the remnant stomach and 26.67% with anastomotic ulcer. Conclusions: The main post-gastrectomy complications were inflammation, ulcer and tumor. The methods of operation and the choice of suture materials have impacts on the causation of complications. Extirpation of the redundant residual sutures under endoscopy might cause amelioration in some cases complications.