保留幽门胃切除术后胃排空功能障碍的原因及防治

保留幽门胃切除术(PPG)治疗早期胃癌(EGC)通过减少胃切除的范围、保留幽门、保留迷走神经能够显著改善患者术后生活质量,降低术后倾倒综合征、胆汁返流及胆石症的发生率。腹腔镜辅助保留幽门胃切除术(LAPPG)将微创理念及功能保留结合,具有低侵袭性,最低限度的小肠麻痹,术后早期康复等优势。然而,无论PPG或LAPPG,术后早期胃排空功能障碍(GEF)的发生率较高,表现为食物长期存留于残胃之中,病人通常有饱腹感。本文综述近几年行PPG术后胃排空功能障碍的相关研究进展,为临床一线外科医生行PPG或LAPPG治疗EGC时防治GEF提供参考建议。

The etiology prevention and treatment of gastric emptying dysfunction Causes and prevention of gastric emptying dysfunction after pyloric preserving gastrectomy

Pylorus-preserving gastrectomy(PPG)for early gastric cancer(EGC)can significantly improve postoperative quality of life and reduce the incidence of postoperative dumping syndrome,bile reflux and cholelithiasis by reducing the scope of gastrectomy,pyloric spare-gastrectomy and vagus nerve spare-gastrectomy.Laparoscopic assisted Pylorus-preserving gastrectomy(LAPPG)combines minimally invasive concepts and functional retention with low invasiveness,minimal intestinal paralysis,and early postoperative gastric empty dysfunction(GEF),which is characterized by prolonged retention of food in the residual stomach and a general feeling of satiety in patients.This article reviews the study of gastric emptying dysfunction after PPG in recent years,and provides recommendations for clinical first-line surgeons to treat gastric emptying dysfunction after PPG or LAPPG treatment of early gastric cancer.