机械吻合在胃大部切除手术的临床应用

目的探讨胃肠吻合器在胃大部切除手术中的应用价值。方法对36例应用胃肠吻合器行胃大部切除术的胃十二指肠溃疡急性穿孔病例进行临床分析。其中十二指肠球部溃疡穿孔28例,胃窦部溃疡穿孔6例,胃小弯溃疡穿孔2例。采用BillrothⅠ式26例,BillrothⅡ式8例,Roux-en-y胃肠吻合2例。结果全组无吻合口瘘,无吻合口狭窄及出血。结论急诊情况下行胃大部切除术应用胃肠吻合器除具有出血少、手术时间短、胃肠功能恢复快、术后并发症少等优点外,还有使手术简单化的优点,值得临床推广应用。

The value of clinical about subtotal gastrectomy surgery with stapling

Objective To investigate the application value of homemade stapler in emergency operation of subtotal gastrectomy.Methods 36 patients with acute perforation of gastroduodenal ulcer were treated by subtotal gastrectomy and homemade stapler were used.The case numbers of the perforations of duodenal bulb ulcer,sinus ventriculi and arcus minor ventriculi ulcer were 28,6 and 2,respectively.Among the total,26 cases were operated by subtotal gastrectomy of BillrothⅠ,8 cases were operated by BillrothⅡand 2 cases were operated by Roux-en-y stomach intestine anastomose.Results Among the total,no case was reported with stoma fistula,stoma stenosis and bleeding. Conclusion There were many advantages to emergency operation of subtotal gastrectomy with homemade stapler,such as less bleeding,shorter time of operation,rapider functional recovery of stomach and intestine,repeatable use and higher safety,moreover,it make the operation easy and simple. It deserves to extend the utilization of homemade stapler in more hospitals.