残胃黏膜病变与胃切除术式的关系

目的分析残胃黏膜病变与胃切除术式的关系。方法回顾566例毕Ⅰ式224例(A组)、毕Ⅱ式207例(B组)和胃食管吻合术135例(C组)]患者的胃镜、幽门螺旋杆菌、吻合口及残胃黏膜组织病理学等检查资料,分析残胃病变与胃切除术式的关系。结果 566例残胃黏膜病变中,吻合口炎占44.0%,残胃炎占72.1%,吻合口溃疡占11.7%,残胃癌占7.1%,反流性食管炎占9.5%,胆汁反流占38.7%。其中,B组中残胃炎、吻合口溃疡、残胃癌、胆汁反流等的发生率均高于A组。C组中反流性食管炎发生率明显高于A组和B组。吻合口炎的发生在三组中无统计学差异。结论残胃黏膜病变与胃切除术式密切相关。

Relationship of the gastric remnant lesions after gastrectomy and reconstructive procedures

Objective To investigate the relationship between the gastric remnant lesions after gastrectomy and reconstructive procedures.Methods Data of 566 patients underwent the surgeries of Billroth-Ⅰ(group A,224 cases),Billroth-Ⅱ(group B,207 cases) and gastroesophagostomy(group C,135 cases) procedures were retrospectively reviewed,who had the gastric remnant lesions after gastrectomy diagnosed by gastroscopic findings,detection of HP infection,and biopsy of the remnant gastric mucosa.The relationship between the gastric remnant lesions after gastrectomy and reconstructive procedures was analyzed.Results Of 566 cases,the incidence rates was 44.0% for anastomotic inflammation,72.1% for remnant gastritis,11.7% for anastomotic ulcer,7.1% for remnant gastric cancer,9.5% for reflux esophagitis,and 38.7% for bile reflux.The incidence rates of remnant gastritis,anastomotic ulcer,remnant gastric cancer and bile reflux were higher in group B than those in group A.The incidence rate of reflux esophagitis was higher in group C than that in groups of A and B.But the incidence of anastomotic inflammation was not significantly different among three groups.Conclusion The gastric remnant lesions after gastrectomy are closely related to the reconstructive procedures.