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作者以往作全胃切除术空肠代胃,一般采用两种术式:一为袢式,即将十二指肠残端闭合,取近端空肠与食管行端侧吻合,输入输出袢之间加行侧侧吻合,此法易行;第二种是截取一段空肠(带血管蒂)移植于食管与十二指肠之间,技术上难度较大。最近,在袢式空肠代胃的基础上,力求维持正常生理通道;作了新设计,这一术式需作两处端侧吻合,两处侧侧吻合,两处截流,为便于命名,简称“2-2-2空肠代胃术”。 1 病历介绍男性,81岁。患者上腹部疼痛,胀滞不适,纳食日减,形体消瘦半年余,近半月解黑便数次,经X线胃透及胃镜检查,确诊浸润型胃体癌(革袋状胃癌),于1995年2月25日收治入院。入院时已基本不能进食,
In the past, the authors used a total gastrectomy for jejunum to replace the stomach. Generally, two methods were used: one is a fistula type, which means that the duodenal stump is closed, and the proximal jejunum and the esophagus are ligated side by side. Lateral side anastomosis, this method is easy; the second is to intercept a section of the jejunum (with vascular pedicle) transplanted between the esophagus and the duodenum, technically more difficult. Recently, on the basis of a jejunal jejunal replacement stomach, it strives to maintain normal physiological pathways; a new design has been made. This procedure requires two end-to-side anastomoses, two side-to-side anastomoses, and two closures, for ease of naming, referred to as “2-2-2 Jejunal stomach surgery.” 1 medical history introduction Male, 81 years old. The patient had pain in the upper abdomen, discomfort in stagnation, daily reduction in food intake, emaciation of the body for more than half a year, and resolution of black stools in the last half-month several times. After X-ray gastroscopy and gastroscopy, it was confirmed that the infiltrating type of gastric body cancer (skin-shaped gastric cancer). February 25, 1995 admitted to hospital. Basically unable to eat at the time of admission,