系统性审查和元分析:布劳恩解剖切除可以改善距离性胃切除术后的比尔罗思II重建吗?
Mustafa Smisim1, Mohammed Alwahibi1, Naif F Aljamlan1
1College of Medicine, King Saud University, Riyadh, SAU.
Cureus
|February 6, 2026
概括
在远端胃切除术后,Billroth II (B-II) 重建中添加的布朗肠胃切除术 (布朗解剖) 并没有显著减少胆汁反流或改善结果. 这种修改增加了操作时间,但与标准B-II重建相比没有明显的好处.
科学领域:
- 胃肠道手术 胃肠道手术
- 手术重建技术 手术重建技术
- 基于证据的医学基于证据的医学.
背景情况:
- 与比尔罗思II (B-II) 重建的远端胃切除术是一种常见的手术.
- B-II重建与胆汁反流和胃切除术后综合征有关.
- 布劳恩 (Braun) 结核结核术是一种抗逆流修饰,但其有效性尚不清楚.
研究的目的:
- 系统地审查和分析B-II重建与布朗解剖结合与单独B-II重建的影响.
- 为了比较结果,包括胆汁反流,动脉并发症和术后结果.
主要方法:
- 在PubMed,Scopus和Web of Science的系统搜索到2025年11月.
- 包括八项回顾性研究 (n=2038名患者),比较B-II+Braun与单独的B-II.
- 使用ROBINS-I评估偏差风险;使用RevMan v.5.4进行的元分析与随机效应模型.
主要成果:
- 在B-II+Braun和B-II单独之间,整体胆汁反流发生率没有显著差异 (RR:0.95).
- 早期术后胆汁反流显示了与B-II+Braun的边缘性减少 (RR:0.57).
- 截止出血和的风险是可比的;B-II+Braun的手术时间明显更长 (MD:19.07分钟).
结论:
- 与单独的B-II相比,Billroth II重建与布劳恩肠肠静脉切除术对胆汁反流或静脉并发症没有持久的益处.
- 添加布朗解剖术增加了手术时间,但没有显著的术后优势.
- 建议采用个性化的重建方法,而不是常规的布朗修饰,需要进一步进行比较研究.
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