The choice of surgical treatment method of perforated pyloroduodenal ulcer

Keywords: peptic ulcer disease; pyloroduodenal ulcer; pylorus stenosis; perforated ulcer; bleeding; penetration; gastrectomy; mobilization of the duodenum.

Abstract

ObjectiveTo develop a method of organ-saving operation aimed at preservation of the physiological function of the pylorus and the normal physiological functioning of the pyloroduodenal area in patients with combined perforated, stenotic pyloroduodenal ulcers.

Materials and methods. The study included 60 patients who faced surgery treatment in relation to complicated combined perforated, stenotic pyloroduodenal ulcers. Depending on diagnostic and surgical tactics applied, patients were conditionally divided into two groups. The control group consisted of 30 patients who underwent standard suturing methods. The main group also consisted of 30 patients in whom the developed method was applicated.

Results. In the control group at the postoperative period of 30 patients operated in different ways complications occurred in 12 persons or in 40% of cases. In the main group of 30 patients operated according to the proposed method, complication in the form of anastomositis occurred in 1 patient only.

Conclusions. The obtained results substantiate recommendation to clinical application the suggested method of organ-saving operation aimed to preserve the physiological function of the pyloroduodenal area, which excludes perforated ulcers suturing without pyloric stenosis elimination and gastrectomy on the background of peritonitis.

Author Biographies

D. V. Maksymchuk, Shupyk National University of Health of Ukraine, Kyiv

D. V. Maksymchuk, Shupyk National Medical Academy of Postgraduate Education, Kyiv
Maksymchuk Dmytro Volodymyrovich, MD, surgeon, postgraduate student
Department of Surgery and Proctology
Shupyk National Medical Academy of Postgraduate Education, Kyiv
Kiev, 11, Vidpochinku, str.
+380661403357,
mdv128@ukr.net
https://orcid.org/0000-0002-8385-6183

V. I. Mamchich, Shupyk National University of Health of Ukraine, Kyiv

V. I. Mamchich, Shupyk National Medical Academy of Postgraduate Education, Kyiv
Mamchich Volodymyr Ivanovich, MD, DSci(Med), Professor
Department of Surgery and Proctology
Shupyk National Medical Academy of Postgraduate Education, Kyiv
Kiev, 11, Vidpochinku, str.
(044) 424-98-27,
surgeryproctology@ukr.net
https://orcid.org/0000-0001-7656-6383

V. D. Maksymchuk, Chornobayiv Multidisciplinary Hospital

V. D. Maksymchuk, Chornobayiv Muldi-Profile Hospital
Maksymchuk Volodymyr Dmitrovich, MD, surgeon
Head of the surgical department
Chornobayev Multidisciplinary Hospital, Cherkasy region, Chornobaivskyi district
19900 Cherkasy region, Chornobay, 5, Chaikovsky str.
+380661649038,
maksimchukvd@ukr.net
https://orcid.org/0000-0001-9531-0711

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Published
2021-03-28
Section
General Problems of Surgery