摘要
远端胃切除术常见消化道重建方式包括BillrothⅠ、BillrothⅡ和Roux—en—Y，这3种方式各具优劣。碱性反流性胃炎（ARG）是远端胃切除术后并发症之一，常见于BillrothII术后。一个世纪以来，为了预防ARG的发生，消化道重建方式不断进行着改良和发展．Roux—en—Y是目前最常用来预防ARG的术式，但该术式会出现停滞综合征，影响患者生活质量，因此亟待更合理的术式。Braun吻合提出于1892年，其目的为解决胃空肠吻合的输入袢综合征，但由于其转流碱性消化液的作用，数十年来逐渐被应用于胰十二指肠切除术和远端胃切除术。有研究表明，Braun吻合可以转流部分碱性消化液，但是其转流量只有少数研究提及。此外．和Roux—en—Y相比，BillrothⅡ＋Braun吻合操作更为安全、简便，同时在预防贫血和营养不良方面可能更具优势。故本文通过回顾文献，对BillrothⅡ＋Braun吻合的历史及目前的研究进展进行综述，以期为临床提供参考。
Methods of digestive tract reconstructionafter distal gastrectomy include Billroth I , Billroth II and Roux-en-Y. Each of them has advantages and disadvantages respectively. Alkaline reflux gastritis （ARG） is one of the complications after distal gastrcctomy, which is common after Billroth II . In the past 100 years, the ways of digestive tract reconstruction have been continuouslyimproved and developed to prevent the occurrence of alkaline reflux gastritis, and Roux-en-Y is one of them. Still, there is a high incidence of Roux stasis syndrome resulting from Roux-en-Y, with impact on quality of life. Therefore, the appropriate reconstruction is needed urgently. Braun anastomosis was proposed in 1892 to lower the incidence of afferent syndrome. Because of its effect of diverting some alkaline digestive juice, it was applied to pancreaticoduodenectomy and distal gastrectomy. Some studies have proved its effect of diverting some alkaline digestive juice, but the diverted quantity was rarely shown. Besides, compared with Roux-en-Y, Billroth II with Braun anastomosis is safer and more convenient. Meantime it is likely to have benefits in aspect of preventing anemia and malnutrition. In order to provide evidence to clinical practice, this article summarizes the history and research advance of Billroth II with Braun anastomosis by reviewing previous reports.
作者
李树春
臧潞
Li Shuchun;Zang Lu(Department of Surgery,Minimally Invasive Surgery Center,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200025,Chin)
出处
《中华胃肠外科杂志》
CAS
CSCD
北大核心
2018年第8期956-960,共5页
Chinese Journal of Gastrointestinal Surgery
