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目的比较胃窦癌合并糖尿病患者二种消化道重建方式的近期并发症及对糖尿病的影响的差异。方法回顾2006年1月—2009年6月我院手术治疗的胃窦癌合并2型糖尿病且入院前未行药物治疗的患者16例,其中8例采用BillrothⅡ吻合;8例采用BillrothⅠ吻合术。结果 BillrothⅡ吻合患者术后糖尿病的治愈率和有效率明显高于行BillrothⅠ吻合的患者,而二种消化道重建方式在术后近期并发症上无差异。结论对于胃窦癌合并2型糖尿病的患者,行根治性远端胃切除D2淋巴结清除术BillrothⅡ式吻合可能是较佳的手术方式。
Objective To compare the short-term complications of two types of digestive tract reconstruction in patients with gastric cancer with diabetes mellitus and their effects on diabetes mellitus. Methods From January 2006 to June 2009, 16 patients with gastric cancer with type 2 diabetes mellitus admitted to our hospital and without prior drug treatment were enrolled. Among them, 8 patients were treated with Billroth Ⅱ anastomosis and 8 patients were treated with Billroth Ⅰ anastomosis. Results The cure rate and effective rate of postoperative diabetes in patients with Billroth Ⅱ anastomosis were significantly higher than those in patients with Billroth Ⅰ anastomosis. However, there was no difference in the postoperative complications between the two types of digestive tract reconstruction. Conclusion For patients with gastric cancer with type 2 diabetes mellitus, radical gastrectomy D2 lymph node dissection Billroth Ⅱ anastomosis may be a better surgical approach.