逆行游离高选择性胃迷走神经切断术治疗十二指肠溃疡

目的：探讨逆行游离高选择性胃迷走神经切断术治疗十二指肠溃疡的可行性和有效性,评估该术式的远期效果,为临床治疗提出新思路。方法：应用逆行游离高选择性胃迷走神经切断术治疗十二指肠溃疡主其工发穿孔、出血和狭窄患者70例,其溃疡穿孔61例,出血6例,狭窄3。结果：65例患者获得访,总的溃复发率为7.69%,再出血率为0。随访30-120个月,属改良VisickⅠ级56例占86.2%,Ⅱ级4例占6.1%,Ⅲ级2例占3.0%,Ⅳ级3例占4.6%,Ⅰ、Ⅱ级共占92.3%。结论：逆行游离高选择性胃迷走神经切断术治疗十二指肠溃疡及其并发症,具有缩短手术时间、简化手术操作、患者远期预后好等优点,可作为治疗十二指肠溃疡合并症的一种有效的方法。

The long-term effects of retrograde liberated highly selective vagotomy in treatment of duodenal ulcer

OBJECTIVE: To evaluate the long-term effects of retrograde liberated highly selective vagotomy (RLHSV) in the treatment of duodenal ulcer. METHODS: Seventy patients with duodenal ulcers complicated by stenosis, bleeding, or perforation were operated on by retrograde liberated highly selective vagotomy. Among these patients, 61 had perforated duodenal ulcers, 6 bleeding and 3 stenosis. RESULTS: Followed up for 30 to 120 months in 65 patients showed a recurrence rate 7.69% and no hemorrhage occurs. According to the modified Visick grading system, 56 patients (86.2%) were of Visick I, 4 (6.1%) of Visick II, 2 (3.0%) Visick III, 3 (4.6%) Visick IV, and (92.3%) Visick I or II. CONCLUSIONS: This modified procedure is rapid, easy and radical operation with excellent long-term results. It can be considered an effective alternative for the treatment of duodenal ulcer with complication.