Objective: To study the effects of highly selective vagotomy plus resection of antral mucosa (HSV+RAM) or highly selective vagotomy (HSV) alone on the motility function of the pyloric antrum. Methods: 48 patients with...Objective: To study the effects of highly selective vagotomy plus resection of antral mucosa (HSV+RAM) or highly selective vagotomy (HSV) alone on the motility function of the pyloric antrum. Methods: 48 patients with duodenal ulcer were studied. 18 dogs were employed as experimental animals. 20 patients were operated on with HSV and 28 with HSV+RAM. The frequency of gastric evacuation and the amplitude of electrogastrography were determined 4 to 6 months after operation. 18 dogs were divided into the control group, HSV group and HSV+RAM group. The time of gastric evacuation, antral myoelectric activity and antral pressure were determined in the dogs 4 to 6 months after operation. The preoperative findings of the patients and the control dogs served as the control. Results: After operation, barium meal revealed that the shape of the stomach and duodenum was normal and the gastric peristalsis was clearly visible in human patients and experimental dogs. In the HSV+RAM group of dogs, the initial evacuation time was (5.0+0.06) min and the time of complete evacuation was (4.0+0.4) h after food-taking, which were similar to those of the control and the HSV group of dogs (P>0.05). The frequency of the antral myoelectric action potential was (3.11+0.65) cycles/min in the dog HAS+RAM group and the frequency of electrogastrography was (3.25+0.75) cycles/min in the human HSV+RAM group, which were significantly lower than those of the control and the dog and human HSV groups (P<0.05). Injection of pentagastrin in dogs and food-taking in human beings significantly increased the antral pressure and the amplitude and frequency of electrogastrography. Conclusion: The findings of this study suggest that the motility function of the reconstructed pyloric antrum in the HSV+RAM group of both the experimental dogs and human patients approaches to the normal even though there is a decrease of antral myoelectric frequency. It is suggested that HSV+RAM should be the first choice for the surgical management of duodenal ulcer.展开更多
文摘Objective: To study the effects of highly selective vagotomy plus resection of antral mucosa (HSV+RAM) or highly selective vagotomy (HSV) alone on the motility function of the pyloric antrum. Methods: 48 patients with duodenal ulcer were studied. 18 dogs were employed as experimental animals. 20 patients were operated on with HSV and 28 with HSV+RAM. The frequency of gastric evacuation and the amplitude of electrogastrography were determined 4 to 6 months after operation. 18 dogs were divided into the control group, HSV group and HSV+RAM group. The time of gastric evacuation, antral myoelectric activity and antral pressure were determined in the dogs 4 to 6 months after operation. The preoperative findings of the patients and the control dogs served as the control. Results: After operation, barium meal revealed that the shape of the stomach and duodenum was normal and the gastric peristalsis was clearly visible in human patients and experimental dogs. In the HSV+RAM group of dogs, the initial evacuation time was (5.0+0.06) min and the time of complete evacuation was (4.0+0.4) h after food-taking, which were similar to those of the control and the HSV group of dogs (P>0.05). The frequency of the antral myoelectric action potential was (3.11+0.65) cycles/min in the dog HAS+RAM group and the frequency of electrogastrography was (3.25+0.75) cycles/min in the human HSV+RAM group, which were significantly lower than those of the control and the dog and human HSV groups (P<0.05). Injection of pentagastrin in dogs and food-taking in human beings significantly increased the antral pressure and the amplitude and frequency of electrogastrography. Conclusion: The findings of this study suggest that the motility function of the reconstructed pyloric antrum in the HSV+RAM group of both the experimental dogs and human patients approaches to the normal even though there is a decrease of antral myoelectric frequency. It is suggested that HSV+RAM should be the first choice for the surgical management of duodenal ulcer.
