摘要
目的探讨胃空肠袢吻合术的近远期疗效。方法统计1983~2000年传统Ⅱ式、Roux-en-Y式、胃空肠袢吻合术3种术式治疗十二指肠球部溃疡共451例的早期并发症,并随访10年以上病例3组共136例,按Visick分级对比、99mTc标记的EHIDA测胆汁肠胃反流指数进行评估。结果早期并发症发生率:胃空肠袢吻合术0(0/101),传统Ⅱ式2.3%(7/305),Roux-en-Y式2.2%(1/45)。10年以上随访:Visick分级,Ⅲ加Ⅳ级:胃空肠袢吻合术(3/60例)明显少于传统Ⅱ式(11/41例,其中残胃痛1例)(P<0.05)和Roux-en-Y式(3/35例,其中吻合口溃疡穿孔1例)。反流指数Ⅲ℃以上:胃空肠袢吻合术(12/60例)明显少于传统Ⅱ式(35/41例)(P<0.05)。结论胃空肠袢吻合术可有效地减少胃切除术后早期并发症和胆汁肠胃反流,近远期疗效均优于传统Ⅱ式和Roux-en-Y式。
Objective To investigate the short-and long-term therapeutic effect of ansiform gastrojejunostomy. Mehtods The data of early complications in 451 cases with duodenal ulcer which underwent Billroth Ⅱ, Roux-en-Y and ansiform gastrojejunostomy from 1983 to 2000 were analyzed. Among above cases, 136 patients, with more than 10 years follow-up, were reviewed by Visick's grading, the regurgitation index of bile by EHIDA marked with 99mTc. Results Early complications showed 0/101 in ansiform gastrojejunostomy, 7/305 in Billwth Ⅱ, 1/45 in Roux-en-Y. Visick's Ⅲ + IV presented 3/60 in ansiform gastrojejunostomy, which was significantly less than that in Billroth Ⅱ(11/41 )and Roux-en-Y(3/35) Beyond regurgitation index ⅢⅢ, ansiform gastrojejunostomy was 12/60 and significantly less than Billroth II (35/41). ConclusIons Ansiform gastrojejunostomy can reduce early postoperative complications and bile regurgitation. Its short- and long-term therapeutic effects are better as compared to Billroth Ⅱ and Roux-en-Y operations.
出处
《中华胃肠外科杂志》
CAS
2001年第1期28-30,共3页
Chinese Journal of Gastrointestinal Surgery