HIGHLY SELECTIVE VAGOTOMY FOR THE TREATMENT OF DUODENAL ULCER(REPORT OF 217 CASES)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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Department of General Surgery, Wuhan Second Municipal Hospital, Wuhan 430014;

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Highly selective vagotomy; Duodenal ulcer; Recurrence; Mucus-deprived antrectomy

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Modified Goligher’s highly selective vagotomy (HSV) for 217 cases of duodenal ulcers is reported. In this series they were: duodenal ulcer (100 cases), combined gastric and duodenal ulcers (79 cases) and complicated perforating, bleeding or stenosed ulcers (38 cases). In the complicated duodenal ulcer, HSV was usually carried out with suturing bleeding point, perforated ulcer or with pyloroplasty. With a follow-up of 3~20 years, the recurrence rate were lt;2% and 85.7% of cases had excellent or good results as Visick classification. Considerations relevant to the HSV technic are deemed worthy of emphasis; complete resection of gastric branches of anterior and posterior vagal trunks and preservation of the first limb of the "Crow’s foot", extended dissection of the distal 5-7cm of the esophagus and division of the distal 8-10cm of the bundle of the gastroepiploic vessels in order to deprive the whole parietal cell mass of its vagal supply. In 4 patients, recurrence were easily controlled with remedies or operation for gastric retention by rational type. The authors suggest that the modified HSV plus mucusdeprived antrectomy be the rational surgical choice for duodenal ulcer.

Citation： Wang Wenlong,Zheng Yinjian,Li Qinyou,et al.. HIGHLY SELECTIVE VAGOTOMY FOR THE TREATMENT OF DUODENAL ULCER(REPORT OF 217 CASES). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 1996, 3(1): 25-28. doi: Copy

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15.	余佩武,王代科,杨顺兴等.高选迷切加胃窦粘膜切除治疗十二指肠溃疡.实用外科杂志,1990;(10)2:82.

1. David J,Ch M,F RCS,et al.Recurrent peptic ulcers.World J Surg,1987;11:274.
2. 黄家驷,吴阶平主编.外科学.第4版.北京:人民卫生出版社,1979:1004.
3. 王代科,詹新思.高度选择性迷走神经切断术的现状和进展.腹部外科,1988;1:81.
4. 郑英键,高有炳.改良高选择性迷走神经切断术治疗十二指肠溃疡.中华外科杂志,1979;17(1):44.
5. 李德春,陈易人.十二指肠溃疡与高选迷切近况.实用外科杂志,1988;(8)5:259.
6. 李庆友,王文龙.高选择性迷走神经切断术治疗十二指肠球部溃疡穿孔的体会.腹部外科,1992;2:78.
7. 王文龙,邹鸿琪,李庆友等.一次性低温全腹腔灌洗治疗腹内严重感染.医师进修杂志,1992;3:73.
8. 黄莛庭.胃十二指肠良性疾病外科诊治的10年进展.实用外科杂志,1991;(11)8,9:423.
9. Rosati I,Serantoni C,Ciani PA.Extended selective proximal vagotomy;Observation on a variant in technique.Chir Gastroenterol,1976;10:33.
10. Johnson AG,Baxta HK.Where is your vagotomy in complete observations on operative technique.Br J Surg,1977;64:583.
11. 郑英键,李庆友,宋式楚等.高选择性迷走神经切断术后复发性溃疡的原因与处理问题.腹部外科,1990;2:57.
12. Amdrup E.The Aarhus county vagotomy trial Ⅰ.An intreim report on primary results and the incidence of sequelace following primary cell vagotomy in 784 patients.World J Surg,1978;2:85.
13. Blackett RL.Recurrent ulceration after highly selective vagotomy for duodenal ulcer.Br J Surg,1981;68:705.
14. Heberer G.Recurrence after proximal gastric vagotomy for gastric,pyloric and prepyloric ulcers.World J Surg,1987;11:283.
15. 余佩武,王代科,杨顺兴等.高选迷切加胃窦粘膜切除治疗十二指肠溃疡.实用外科杂志,1990;(10)2:82.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

HIGHLY SELECTIVE VAGOTOMY FOR THE TREATMENT OF DUODENAL ULCER(REPORT OF 217 CASES)

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