scholarly journals Epidemiology and treatment of perforated duodenal ulcer in Kemerovo Region

2020 ◽  
Vol 5 (2) ◽  
pp. 67-71
Author(s):  
V. I. Podoluzhnyi ◽  
A. B. Startsev ◽  
I. A. Radionov
Keyword(s):  
Duodenal Ulcer ◽  
Surgical Treatment ◽  
Gastric Acid ◽  
Proteolytic Activity ◽  
Pyloric Stenosis ◽  
Gastric Resection ◽  
Perforated Duodenal Ulcer ◽  
Surgical Interventions ◽  
Ulcer Complications ◽  
Clinical Emergency

Aim. To estimate the frequency of ulcerative bleeding, pyloric stenosis, need for pyloroplasty and the justification of vagotomy for perforated duodenal ulcer.Materials and Methods. We analyzed the surgical treatment of patients with perforated duodenal ulcer admitted to Podgorbunskiy Regional Clinical Emergency Hospital during 1999-2019.Results. In 2018, the number of surgical interventions due to perforated duodenal ulcer decreased by 56.4% in comparison with 1998. In 8.6% and 2.1% of patients, perforated duodenal ulcer was combined with pyloric stenosis and bleeding, respectively, requiring Judd pyloroplasty (diamond- shaped transverse excision) or gastroduodenotomy followed by Heineke-Mikulicz pyloroplasty (transversely closed longitudinal incision across the pylorus) and vagotomy. Distal gastric resection by Billroth’s operation II was required in 2.8% of patients. Repeated admission of patients with duodenal ulcer complications has been observed after isolated suturing of perforated duodenal ulcer.Conclusion. Over the last 20 years, the amount of surgical interventions because of perforated duodenal ulcer in Kemerovo Region decreased more than twofold. In > 10% patients, pyloric stenosis and bleeding require a gastric drainage. In > 8% patients, perforated duodenal ulcer is combined with pyloric stenosis; in these cases, Heineke-Mikulicz pyloroplasty may be a treatment of choice. In > 2% patients, perforated duodenal ulcer is combined with ulcerative bleeding requiring excision of the ulcer and optional distal gastric resection. Pyloroplasty may be combined with vagotomy to normalise the proteolytic activity of gastric acid.

scholarly journals Need for pyloroplasty and vagotomy in case of perforated duodenal ulcer

2020 ◽  
Vol 46 (1) ◽  
pp. 56-59
Author(s):  
V. I. Podoluzhniy ◽  
A. B. Startsev ◽  
I. A. Radionov
Keyword(s):  
Duodenal Ulcer ◽  
Surgical Treatment ◽  
Gastric Resection ◽  
Surgical Intervention ◽  
Posterior Wall ◽  
Anterior Wall ◽  
Ulcer Formation ◽  
Perforated Duodenal Ulcer ◽  
Selective Proximal Vagotomy ◽  
Lesser Curvature

Aim. Estimation of the incidence of stenosis, need for pyloroplasty and validity of vagotomy for perforated duodenal ulcer (PDU). Materials and methods. Twenty-year nature of surgical treatment of patients with PDC in the hospital surgery clinic is analyzed. Results. Over 20 years, 726 patients were operated on: 151 women (20.8%), 575 men (79.2%), mean age 39.1±6.3 years. Surgeries were performed both from laparotomic access and video laparoscopically. It is found that PDU is combined with stenosis in 8.5% and with bleeding in 1.6%, which requires Jadd excision of an ulcer on the anterior wall or gastroduodenotomy for flashing a bleeding ulcer on the posterior wall (0.7%) with subsequent Heineke — Mikulicz pyloroplasty and vagotomy. Both stem vagotomy and selective proximal were used by the method of skeletonization of lesser curvature or chemoneurolysis. Suturing with selective proximal vagotomy was performed in 567 patients, isolated suturing — in 77. B-II distal gastric resection was required in 2.1%. Repeated admission of patients with complications of a duodenal ulcer is observed after isolated suturing of PDU without surgical intervention in the mechanisms of ulcer formation. Conclusion. During surgical treatment of PDU are found in 79.2% of men, in 20.8% of women. There is an emerging stenosis in 8.5% of those who have PDU, which requires a gastric drainage operation. The subjects of choice may be Heineke-Mikulicz pyloroplasty or Jadd excision of an ulcer on the anterior wall. It is advisable to suture or excise an ulcer with pyloroplasty accompanied by vagotomy that normalizes the acid-proteolytic activity of gastric juice in the postoperative period and eliminates need for antisecretory drugs to prevent the recurrence of the disease.

scholarly journals Therapeutic tactics in the deep forms of rectal abscesses complicated by fournie gangrene

2020 ◽  
Vol 73 (2) ◽  
pp. 293-297
Author(s):  
Oleh E. Kanikovskyi ◽  
Andrii V. Osadchyі ◽  
Sergey I. Androsov ◽  
Anatolii V. Tomashevsky ◽  
Oleh A. Yarmak ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Antibacterial Therapy ◽  
Treatment Duration ◽  
Complex Treatment ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Surgical Clinic ◽  
Modern Technologies ◽  
Clinical Emergency ◽  
Early Surgical Treatment

The aim: To conduct an analysis of the complex treatment of severe forms of rectal abscesses complicated by NF. Materials and methods: The results of treatment in 471 patients with deep forms of RA was performed. In 38(8%) the spread of the process and rotten-necrotic affection of the perineal fascia. Patients were treated at the surgical clinic of the medical faculty №2, VNPMMU, and Vinnytsya Clinical Emergency Hospital in the period from 2010-2018. Results: Total lethality 8(1,7%). Mortality in GF was 8(19,5%). It is worth noting the reduction of the treatment duration against the background of the modern technologies usage in the period from 2016 to 12 days in relation to the total figure of 15 days. Conclusions: Early surgical treatment, adequate necrectomy, fasciotomy and antibacterial therapy stop the necrotic process. The active aspiration reduces the timing of wound cleansing and further ensures the accelerated implementation of reconstructive surgical interventions.

Incidence of Duodenal Ulcer and its Surgical Management in a Teaching Hospital in Bangladesh

1995 ◽  
Vol 25 (2) ◽  
pp. 67-68 ◽  
Author(s):  
Meer Mahbubul Alam
Keyword(s):  
Duodenal Ulcer ◽  
Surgical Treatment ◽  
Surgical Management ◽  
Teaching Hospital ◽  
Pyloric Stenosis ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
High Incidence

Duodenal ulcer patients with or without complications admitted in the surgical departments of Rajshahi Medical College Hospital (RMCH) during the period of 13 years from 1980–1992 were studied retrospectively. Duodenal ulcer accounted for 10/1000 admission and five operations per week. Of the 1623 patients with uncomplicated ulcer, only 623 needed surgical treatment. However, all of the 1599 who presented with pyloric stenosis, 1047 with peritonitis due to perforation, and 13 with hematemesis were operated upon. This study confirms previously published reports of high incidence of duodenal ulcer admissions in the hospital but shows a diminishing number in the uncomplicated cases requiring surgery.

scholarly journals Indication of Non-surgical Treatment for Perforated Duodenal Ulcer

2001 ◽  
Vol 26 (6) ◽  
pp. 1403-1406 ◽  
Author(s):  
Ryouichi TOMITA ◽  
Shigeru FUJISAKI ◽  
Tarou IKEDA ◽  
Eichi PARK ◽  
Masahiko SHIBATA ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Surgical Treatment ◽  
Perforated Duodenal Ulcer ◽  
Non Surgical Treatment

Emergency surgical treatment for bleeding duodenal ulcer: Oversewing plus vagotomy versus gastric resection, a controlled randomized trial

1993 ◽  
Vol 17 (5) ◽  
pp. 568-573 ◽  
Author(s):  
Bertrand Millat ◽  
Jean-Marie Hay ◽  
Patrice Valleur ◽  
Abe Fingerhut ◽  
Pierre-Louis Fagniez ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Surgical Treatment ◽  
Randomized Trial ◽  
Gastric Resection ◽  
Bleeding Duodenal Ulcer

Surgical Treatment of Perforated Duodenal Ulcer with The use of a Mini-Access

2019 ◽  
Vol 12 (4) ◽  
pp. 1601
Author(s):  
Nazarbek B. Omarov ◽  
Meirbek Z. Aymagambetov ◽  
Farida S. Raikhimzhanova ◽  
Aidar D. Raimkhanov
Keyword(s):  
Duodenal Ulcer ◽  
Surgical Treatment ◽  
Perforated Duodenal Ulcer

Surgical Treatment of Perforated Duodenal Ulcer in The Netherlands

1986 ◽  
Vol 3 (4) ◽  
pp. 311-316 ◽  
Author(s):  
U.J.L. Reynders ◽  
H.F.W. Hoitsma ◽  
S. Meijer ◽  
G.L. van Rij
Keyword(s):  
Duodenal Ulcer ◽  
Surgical Treatment ◽  
The Netherlands ◽  
Perforated Duodenal Ulcer

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.

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