scholarly journals Surgical treatment of complicated duodenal ulcers with different variants of their localization

2021 ◽  
Vol 11 (9) ◽  
pp. 773-780
Author(s):  
D. Maksymchuk ◽  
V. Mamchych ◽  
V. Maksymchuk
Keyword(s):  
Duodenal Ulcer ◽  
Surgical Treatment ◽  
Gastrointestinal Bleeding ◽  
Surgical Techniques ◽  
Clinical Protocols ◽  
Duodenal Ulcers ◽  
The Third ◽  
Alternative Method ◽  
Pyloric Canal

Purpose: To analyze and highlight the most effective methods of surgical treatment of complicated duodenal ulcer (DU) depending on its location. Material and methods. 86 patients underwent surgery for complicated combined pyloroduodenal ulcers. All patients with signs of gastrointestinal bleeding and perforation were examined according to clinical protocols. Patients were operated on by various surgical techniques depending on the location of DU. Further the analysis of different methods of surgical treatment of the pathology under study at its various localizations was carried out. Results. It has been established that in complicated combined pyloroduodenal ulcers with localization in the pyloric canal antrumectomy is the method of priority. If duodenum ulcer is complicated by bleeding, excision with pyloroplasty is the method of priority. Suture ulceration with pyloroplasty can be considered as an alternative method of treatment. It has been verified that in complicated duodenal ulcers, exteriorization and suturing of the ulcer have the lowest efficiency. The most frequently used method of duodenal ulcers of any localization treatment was excision of the ulcer with pyloroplasty. 6 (41.8 ± 0.053%).patients had been operated on by this method. In the second place in terms of universality was ulcer’s suturing with pyloroplasty - 22 patients or (25.5 ± 0.047%). The third was the method of exteriorization and suturing of ulcers, which accounted for 10 patients (11.6 ± 0.034%).

scholarly journals Efficacy of intravascular embolization in profuse hemorrhage from complicated duodenal ulcers

2021 ◽  
Vol 88 (5-6) ◽  
pp. 12-17
Author(s):  
D. V. Maksymchuk ◽  
V. І. Mamchich ◽  
V. D. Maksymchuk
Keyword(s):  
Duodenal Ulcer ◽  
Surgical Treatment ◽  
Pancreatic Head ◽  
Early Recurrence ◽  
Main Group ◽  
Treatment Quality ◽  
Duodenal Fistula ◽  
Duodenal Ulcers ◽  
Standard Methods ◽  
Profuse Hemorrhage

Objective. To estimate the efficacy of intravascular embolization in profuse hemorrhage from complicated duodenal ulcers. Materials and methods. Into the investigation 80 patients were included, operated for the profuse hemorrhage complication of duodenal ulcers, penetrating into pancreatic head. The patients were distributed into two groups: the control - 40 patients, in whom the standard methods of the hemorrhage arrest were applied, and the main - 40 patients, in whom the method elaborated was used. Results. In the main group in postoperative period the complications have had occur in 1 (2.5±0.2%) patients (p<0.001) only - the duodenal fistula development. There was verified, that the best results of hemostasis in hemorrhage from penetrating duodenal ulcers were obtained in the patients of the main group, in whom іntraoperative endovascular arrest of the hemorrhage together with the ulcer suturing was applied, because in 100% of patients of this group the definite hemostasis was achieved. Conclusion. The proposed method of intraoperative endovascular arrest of hemorrhage from penetrating duodenal ulcer guarantees a qualitative hemostasis, lowers the rate of the hemorrhage early recurrence and the need for relaparotomy performance, and raises the surgical treatment quality.

scholarly journals Analysis of surgical treatment of duodenal ulcers with multiple combined complications

2021 ◽  
pp. 10-12
Author(s):  
Pavlo Ivanchev ◽  
Maxim Bilyachenko ◽  
Anton Kurbanov ◽  
Oleksii Lissov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Mortality ◽  
Bleeding Complications ◽  
Duodenal Ulcers ◽  
The Third ◽  
Number Of Patients ◽  
Group A ◽  
Analysis Of Results ◽  
Surgical Tactics ◽  
Group B

The aim of the research. Analysis of results and development of surgical tactics for the treatment of DU with multiple combined complications. Materials and methods. The results of the analysis of surgical treatment of duodenal ulcers with multiple combined complications (3 and 4 combined complications) for 3 periods are presented: 1st (1983–1995) (group A) – 77 patients, 2nd (2000–2007) years (group B) – 30 patients and 3rd (2008–2020) (group C) – 46 patients. Results. 153 patients (100 %) underwent surgery for complicated duodenal ulcer (DU), of which 130 patients (84.9 %) had a combination of three complications and 23 (15.1 %) had four complications. Bleeding complications were noted in 139 of 153 patients, accounting for 90.8 %, and ulcer perforation in 69 patients, accounting for 45.1 % of all other complications. Based on the obtained data of the analysis, there is a steady tendency to increase the proportion of organ-preserving operations (OPO) by 1.5 times (from 50.7 % to 76.2 %), reducing the number of gastrectomy (GR) by 3 times (from 14.5 % to 4.8 %) and palliative operations (PAL) 3.3 times (from 15.8 % to 4.8 %) with a relatively stable number of performed organ-saving operations (OSO): in group A – 17 (24.6 %) interventions, in group B – 4 (21.1 %), group C – 6 (14.3 %). Conclusions. The use of modern measures of endoscopic hemostasis allowed to operate on patients in the delayed period, and their share from the second period to the third increased 2.8 times. The number of patients who underwent emergency surgery with perforation of the ulcer as one of the complications decreased in the third period compared to the second by 2.6 times, due to the widespread use of PPIs in the conservative treatment of DU. According to the results of the analysis it became known that the chosen active-individualized tactics and developed algorithms for choosing the type of surgery allowed to achieve a stable level of postoperative mortality at 8.3 %.

scholarly journals Indications and Findings of Upper Endoscopies in Males and Females, Are They the Same or Different?

2021 ◽  
Vol 10 (8) ◽  
pp. 1620
Author(s):  
Naim Abu-Freha ◽  
Roni Gat ◽  
Aerin Philip ◽  
Baha Yousef ◽  
Liza Ben Shoshan ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Abdominal Pain ◽  
Gastroesophageal Reflux ◽  
Gastrointestinal Bleeding ◽  
Upper Endoscopy ◽  
Sex And Gender ◽  
Duodenal Ulcers ◽  
Males And Females ◽  
Similarities And Differences ◽  
And Gender

Sex and gender can affect the prevalence and prognosis of diseases. Our aim was to assess similarities and differences for males and females who underwent an upper endoscopy, with regards to indications and results. We reviewed all upper endoscopy reports from 2012 to 2016. Data regarding demographics, indications, and procedure findings were collected. The upper endoscopy findings were compared regarding the most common indications: gastroesophageal reflux, abdominal pain, gastrointestinal bleeding, and anemia. We investigated 12,213 gastroscopies among males (age, 56.7 ± 17.4) and 15,817 among females (age, 56.0 ± 17.3, p = 0.002). Males who underwent an upper endoscopy for gastroesophageal reflux had higher rates of esophagitis (7.7% vs. 3.4%, p < 0.001) and Barret’s esophagus (4.4% vs. 1.5%, p < 0.001). Females who underwent an upper endoscopy for abdominal pain had a higher rate of hiatal hernia, whereas males had higher rates of esophagitis, helicobacter pylori infection, gastritis, gastric ulcer, duodenitis, and duodenal ulcer (p < 0.001). Gastrointestinal bleeding as an indication for upper endoscopy showed that helicobacter, duodenitis, and duodenal ulcers are more common among males compared to females (p < 0.001). Males with anemia who underwent an upper endoscopy had higher rates of esophagitis (p = 0.021) gastritis (p = 0.002), duodenitis (p < 0.001), and duodenal ulcer (p < 0.001). We found significant differences regarding the pathological gastroscopy findings between males and females in relation to the different indications.

scholarly journals SURGICAL TREATMENT OF PRIMARY INTRA-ABDOMINAL COMPLICATIONS: ABSCESSES AND INFILTRATES

2021 ◽  
Vol 8 (1) ◽  
pp. 30-36
Author(s):  
V. Skyba ◽  
V. Rybalchenko ◽  
O. Ivanko ◽  
N. Voytyuk ◽  
Dar Yasin Akhmed
Keyword(s):  
Duodenal Ulcer ◽  
Gastric Ulcer ◽  
Surgical Treatment ◽  
Underlying Disease ◽  
Control Group ◽  
Serous Membrane ◽  
The Third ◽  
Perforated Gastric Ulcer ◽  
Open Laparotomy ◽  
Male Patients

Purpose of the work. improving the results of surgical treatment of patients with primary intra-abdominal infiltrates and abscesses. Material and methods. From 2006 to 2019, 191 patients with primary intra-abdominal infiltrates and abscesses were treated. The patients' age ranged from 16 to 85 years. There were 96 male patients (50.26%), 95 female patients (49.74%). Results. The patients were divided into 3 subgroups depending on the underlying disease. The first group included 74 (38.74%) patients with destructive appendicitis, of which 39 (20.42%) were in the control group, and 35 (18.32%) were studied. The second group included 48 (25.13%) patients suffering from perforated gastric ulcer and 12 duodenal ulcer, of which the control group was 26 (13.61%), and the studied group was 22 (11.52%). The third group included 69 (36.13%) patients with cholecystitis, of which 37 (19.37%) were in the control group, and 32 (16.76%) were studied. All patients were operated on. Conclusions. Surgical treatment is individualized depending on the disease, so with destructive appendicitis from 74 (38.74%) laparotomic in 42 (21.99%), laparoscopic in 32 (16.75%), and in 12 (6.28%) with conversion; perforated gastric ulcer and 12 duodenal ulcer in 48 (25.13%) open laparotomy; with cholecystitis from 69 (36.13%) in 48 (25.13%) laparotomic and in 21 (11.00%) laparoscopically. The use of water-jet technologies in 64 (33.51%) patients made it possible to minimize damage to the serous membrane and cleanse the peritoneum from acquired formations.

Gastric and 12 duodenal ulcer from a surgical point of view

1934 ◽  
Vol 30 (2) ◽  
pp. 261-276
Author(s):  
N. V. Sokolov
Keyword(s):  
Duodenal Ulcer ◽  
Surgical Treatment ◽  
Scientific Data ◽  
Past Experience ◽  
Point Of View ◽  
Present Stage ◽  
Duodenal Ulcers

To put the question of gastric and duodenal ulcer from the surgical point of view means to decide more or less definitely whether a gastric and duodenal ulcer at the present stage of our knowledge of this painful form can be treated surgically and what are the indications for surgical treatment; it means to decide the choice of this or that method of surgical treatment of gastric and duodenal ulcers, proceeding in this question based on past experience covered by modern scientific data.

scholarly journals SURGICAL APPROACH IN CONCOMITANT COMPLICATIONS OF DUODENAL ULCER

2018 ◽  
Vol 5 (4) ◽  
pp. 165-170
Author(s):  
F. Nishanov ◽  
B. Abdullajonov ◽  
M. Nishanov ◽  
J. Rustamov ◽  
B. Ibragimov ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Surgical Treatment ◽  
Surgical Approach ◽  
Therapeutic Approach ◽  
Gastric Resection ◽  
Optimal Treatment ◽  
Duodenal Ulcers ◽  
Treatment Methods ◽  
Specific Complication

SURGICAL APPROACH IN CONCOMITANT COMPLICATIONS OF DUODENAL ULCERNishanov F., Abdullajonov B., Nishanov M., Rustamov J., Ibragimov B., Mishenina E.Authors analyzed results of surgical treatment in 307 patients with concomitant complications of duodenal ulcer. Patients were divided into 2 groups according to the chosen diagnostic and therapeutic approach. The first group comprised 168 (54.7%) patients who underwent “traditional” gastric resection while the second group included 139 (45.3%) patients who underwent modifying variants of gastric resection.It was established that improvement of definite operation types and employment of optimal treatment methods can result in a decrease in frequency of early postoperative specific complication by 8.3% (from 15.5 to 7.2%, р<0.01), frequency of re-laparotomy by 4.3 (from 6.5 to 2.2%) and mortality by 2.2% (from 2.9 to 0.7%, р<0.05), and this gives a possibility to improve the results of surgical treatment of concomitant complications of duodenal ulcers in whole.Key words: duodenal ulcer, gastric resection, re-laparotomy, modification variants. РезюмеХІРУРГІЧНА ТАКТИКА ПРИ ПОЄДНАНИХ УСКЛАДНЕННЯХ ВИРАЗКОВОЇ ХВОРОБИ ДВАНАДЦЯТИПАЛОЇ КИШКИНішанов Ф., Абдуллажанов Б., Нішанов М.Ф, Рустамов Ж., Ібрагімов Б., Мішеніна К.Автори аналізують результатів хірургічного лікування 307 пацієнтів з поєднаними ускладненнями ВХДПК.Хворих в залежності від застосованої діагностичної та хірургічної тактики умовно поділили на 2 групи. Першу контрольну групу склали 168 (54,7%) пацієнтів,яким були виконані «традиційні» варіанти резекції шлунка, другу основну групу склали 139 (45,3%) пацієнтів,яким були виконані модифіковані варіанти резекції шлунка.Встановлено,щоудосконалення окремих технічніхприйомів операції та застосування оптимальних способів лікування ускладнень,дозволяють знизити частоту ранніх післяопераційних специфічних ускладнень на 8,3% (з 15,5 до 7,2%,р <0,01), частоту релапаротомій на 4,3 (з 6,5 до 2,2%) і летальних випадків на 2,2% (з 2,9 до 0,7%, р <0,05), тим самимсприяючи поліпшенню результатів хірургічного лікування поєднаних ускладнень дуоденальних виразок в цілому.Ключові слова: язвена хвороба дванадцятипалої кишки, резекція шлунку, релапаратомія, модифіковані варіанти. РезюмеХИРУРГИЧЕСКАЯ ТАКТИКА ПРИ СОЧЕТАННЫХ ОСЛОЖНЕНИЯХ ЯЗВ ДВЕНАДЦАТИПЕРСТНОЙ КИШКИНишанов Ф., Абдуллажанов Б., Нишанов М., Рустамов Ж., Ибрагимов Б., Мишенина Е.Авторы анализируют результатов хирургического лечения 307 пациентов с сочетанными осложнениями ЯБДПК. Больных в зависимости от примененной диагностической и хирургической тактики условно разделили на 2 группы. Первую контрольную группу составили 168 (54,7%) пациентов, которым были выполнены традиционные варианты резекции желудка, вторую основную группу составили 139 (45,3%) пациентов которые были выполнены модифицированные варианты резекции желудка.Установлено, что усовершенствованные отдельные технические приемы операции и применение оптимальных способов лечения возникших осложнений позволяют снизить частоту ранних послеоперационных специфичных осложнений на 8,3% (с 15,5 до 7,2% р<0,01), частоту релапаротомии на 4,3 (с 6,5 до 2,2%) и летальных исходов – на 2,2% (с 2,9 до 0,7%, р<0,05), тем самым способствуя улучшению результатов хирургического лечения сочетанных осложнений дуоденальных язв в целом.Ключевые слова:язвенная болезнь желудка, резекция желудка, релапаратомия, модифицированные варианты.

scholarly journals «Low-Invasive» A Way Of Surgical Treatment Ulcer Pyloric-Duodenal Stenosis

2020 ◽  
Vol 02 (11) ◽  
pp. 115-119
Author(s):  
Djamalov S.I. ◽  
◽  
Aripova N.U. ◽  
Israilov B.N. ◽  
Pulatov M.M. ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Stomach Ulcer ◽  
Frequency Of Occurrence ◽  
Duodenal Stenosis ◽  
Third Place ◽  
Duodenal Ulcers ◽  
The Third ◽  
Life Threatening

The pyloric-duodenal stenosis (PDS) concerns frequent complications of stomach ulcer and takes the third place after such life-threatening complications duodenal ulcers as punching and ulcer gastrointestinal bleedings. Frequency of occurrence ulcer PDS makes, according to different researchers, 10-18 % and are diagnosed mainly for patients with is long proceeding duodenal an ulcer. Quite often there is simultaneous combination PDS to other complications of stomach ulcer of a duodenal gut that by all means complicates treatment tactics.

What type of vagotomy for duodenal ulcer?

1974 ◽  
Vol 12 (8) ◽  
pp. 29-31
Keyword(s):  
Duodenal Ulcer ◽  
Surgical Treatment ◽  
Gastric Acid ◽  
Social Life ◽  
Acid Output ◽  
Partial Gastrectomy ◽  
Duodenal Ulceration ◽  
Gastric Acid Output ◽  
Duodenal Ulcers

By convention, vagotomy means the division of all or part of the vagus in the abdomen. Gastric acid output falls by 50 – 70% after vagotomy, allowing duodenal ulcers to heal in most patients. Since its introduction in 1943 the operation has been much modified, and has largely replaced partial gastrectomy in the elective surgical treatment of uncomplicated chronic duodenal ulceration. In general, the need for operation is determined by the severity and duration of the symptoms, and the extent to which they interfere with the patient’s work and social life.

scholarly journals THE WAY OF RECONSTRUCTIVE SURGERY IN CHRONIC DUODENAL ULCER, COMPLICATED BY BLEEDING WITH SEVERE BLOOD LOSS AFTER RETROCOLIC GASTROJEJUNOSTOMY

2017 ◽  
Vol 9 (2) ◽  
pp. 131-134
Author(s):  
B V Sigua ◽  
V P Zemlyanoy ◽  
A M Danilov ◽  
S E Klimov ◽  
O A Romanenko ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Surgical Treatment ◽  
Mortality Rate ◽  
Blood Loss ◽  
Gastrointestinal Bleeding ◽  
High Mortality ◽  
Reconstructive Surgery ◽  
Bleeding Source ◽  
Chronic Duodenal Ulcer ◽  
Successful Case

Currently, surgical treatment of gastrointestinal bleeding is based primarily on topical preoperative identification of their source. In this regard, the treatment of patients with bleeding from unknown sources is a difficult task and is accompanied by a high mortality rate. In such cases, in the absence of confirmation of gastrointestinal bleeding source, treatment should base on the clinical pic- ture. A successful case of surgical treatment of patient with chronic duodenal ulcer, complicated with bleeding after retrocolic gastroenteroanastomy is described.

scholarly journals Method of diagnosis and treatment of profusional bleeding from stenosing postbulbar ulcers of the duodenum

2021 ◽  
pp. 37-43
Author(s):  
Volodymyr Mamchych ◽  
Sergiy Vereshchagin ◽  
Volodymyr Maksymchuk ◽  
Dmytro Maksymchuk
Keyword(s):  
Duodenal Ulcer ◽  
Surgical Treatment ◽  
Clinical Protocols ◽  
Artery Embolization ◽  
X Ray ◽  
Endovascular Interventions ◽  
Superselective Embolization ◽  
Near Future ◽  
Damaged Vessel ◽  
Angiography And Embolization

The aim. To evaluate the effectiveness of X-ray interventions in arosive bleeding in patients with complicated duodenal ulcer. Materials and methods. X-ray endovascular interventions were used in 8 patients who developed arosive bleeding as a complication of duodenal ulcer. All patients with signs of gastrointestinal bleeding were examined according to clinical protocols. Hemodynamically stable patients underwent X-ray endovascular interventions. Results and discussion. In the near future, bleeding stopped in all 8 (100 %, OR–0.04 [0.005–0.29], p=0.03) patients. On day 2, two patients who underwent embolization of their own hepatic artery had a recurrence of bleeding (0.56 [0.065–4.76], p=0.29). Repeated angiography and embolization attempts were ineffective, and both patients died. In patients who underwent gastroduodenal and pancreatouodenal artery embolization, bleeding did not resume. Thus, we obtained good results as 6 out of 8 patients recovered (75 %), despite the severity of their condition and a disappointing prognosis (OR–9.0 [1.0–46.7], p <0.05). Conclusions. Adherence to the tactics mentioned above in the treatment of bleeding in duodenal ulcer was highly effective, especially in superselective embolization with the detection of bleeding gel. If the presence of arosive bleeding is confirmed, emergency surgical treatment with suturing of the damaged vessel is shown in hemodynamically unstable patients, and endovascular intervention is possible in hemodynamically stable patients. Further studies are needed to determine the criteria for a high risk of arosive bleeding developing in patients with complicated duodenal ulcer as well as to prevent its occurrence through the use of X-ray endovascular interventions.

Sign in / Sign up

Export Citation Format

Share Document