近端胃大部切除“P”型袢空肠间置术式的临床研究

为探讨近端胃大部切除后,在重建胃肠道中能有效地抗返流性食管炎的术式,1995年5月至1997年6月,前瞻性对9例贲门癌病人,作近端胃大部切除,采用带血管蒂“P”型袢空肠段,间置于食管下段与残胃之间。术后3个月,应用食管pH监测仪作24h定位测定和纤维胃镜检查及1年的临床生活质量随访。结果表明,该术式的食管下端与“P”型袢空肠间置的吻合周围PH处于弱碱性稳定状态,未见有反酸性炎症反应,饮食状况良好。

CLINICAL STUDY OF "P" LOOP JEJUNAL INTERPOSITION FOLLOWING THE PROXIMAL GASTRECTOMY

Objective: To prevent the reflux esophagitis following proximal gastrectomy. Method:"P" loop jejunal interposition was located between the lower end of the esophagus and distal residual stomach following the proximal gastrectomy for 9 pateints with cardia carcinoma. Three months later, 24 - hr lower intraesophageal pH and tissue biopsy through gastroscopy were performed in all the patients, and they were further followed up for one year. Result: The pH around the anastomosis between the lower end of the esophagus and the interposed "P" loop jejunum was of stabile alkalinity, no reflux acid inflammation was shown there. Couclusion; It is an ideal method of gastrointestinal reconstruction following proximal gastrectomy.