Forty-two patients with duodenal ulcer underwent highly selective vagotomy and mucosal antrectomy (HSV+MA) and were followed up for 3 years. Two weeks, 1 year and 3 year after operation, serum gastrim level and gastric emptying capacity were tested. The results show that he postoperative levels of serum gastrin were lower than the preoperative ones, but wih no significant difference (Ｐ＞0.05). Only a few patients had delayed gastric emptying 2 weeks and 1year after operation,but it returned to normal in 3 years .The authors conclude that HSV+MA is a better operative treatment for duodenal ulcer since it can abolish the factors of postoperative ulcer recurence and perserve the functions of the antrum and the pylorus.
Abstract: Objective To evaluate the effect on gastroesophageal reflux and gastric emptying in the different route of gastroesophageal anastomosis objectively after esophagectomy for patients with midesophageal carcinoma. Methods Forty patients with midesophageal carcinoma were randomly divided into two groups. Esophageal bed group (n=20): the gastroesophageal anastomosis were performed while the stomach were pulled on through the esophageal bed after esophagectomy; endothoracic group (n=20): gastroesophageal anastomosis were performed while the stomach were pulled on in the thoracic cavity. Ten persons had no disease of digestive system and healthy volunteers were recruited as normal control group. 24-hour esophageal pH monitoring and radioisotope gastric emptying checkup were carried out in all experimental subjects 3 months after operation, so as to observe the changes of gastroesophageal reflux and gastric emptying. Results All of the patients’s operation were success. And no anastomotic leakage and no anastomotic stenosis. Three months after operation, the patients in both operation groups were with different level of reflux. DeMeester total appraise score, the times of regurgitation of gastric juice in 24h, gt;5 min reflux frequency, the longest time of keep reflux, pHlt;4.00 total time and pHlt;4.00 of total time percent, these targets in both operation groups were higher than those in control group (Plt;0.01) DeMeester total appraise score, the times of regurgitation of gastric juice in 24 hours, the longest time of keeping reflux, pHlt;4.00 of total time and pHlt;4.00 of total time percent in esophageal bed group were lower than those in endothoracic group(Plt;0.01). The recent period of gastric emptying percentage (GE) in both operative groups were lower than that in normal control group. GE in esophageal bed group experimental meal in the stomach after entering the 30,60,90,120,180 and 240 min were higher than those in endothoracic group. Conclusion After the operation of esophagogastric anastomosis through esophageal bed in upper aortic site,gastroesophageal reflux and delayed gastric emptying exist objectively, However, the technique is superior to the traditional technique to reduce the extent of gastroesophageal reflux and delayed gastric emptying, its mechanism might be the result of mechanical factors.