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 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 Recurrent Peptic Ulcer Perforation: A Case Report

2022 ◽  
Vol 7 (01) ◽  
pp. 62-65
Author(s):  
Maather Al Abri, MD ◽  
Ghaitha Al Mahruqi, MD ◽  
Hani Al Qadhi, FRCSC
Keyword(s):  
Duodenal Ulcer ◽  
Peptic Ulcer ◽  
Case Report ◽  
Surgical Treatment ◽  
Surgical Intervention ◽  
Peptic Ulcer Perforation ◽  
Perforated Duodenal Ulcer ◽  
Peptic Ulcers ◽  
Ulcer Perforation

Background: Refractory peptic ulcers are ulcers in the stomach or duodenum that do not heal after eight to twelve weeks of medical/surgical treatment or those that are associated with complications despite medical tssreatment. We herein present a case of a 44 year old man with a recurrent perforated duodenal ulcer requiring emergent surgical intervention.

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.

scholarly journals Selective mucosectomy - a method of surgical treatment of gastric ulcer and duodenal ulcer

1982 ◽  
Vol 63 (3) ◽  
pp. 28-31
Author(s):  
I. A. Salikhov ◽  
D. I. Gafurov ◽  
A. A. Agafonov
Keyword(s):  
Duodenal Ulcer ◽  
Gastric Ulcer ◽  
Surgical Treatment ◽  
Mucous Membrane ◽  
Nerve Plexus ◽  
Functional Study ◽  
Surgical Practice ◽  
Secretory Potential ◽  
Lesser Curvature ◽  
Stable Reduction

Selective mucosectomy is proposed, in which the mucous membrane of the lesser curvature of the stomach is removed, followed by sutures covering the demucosated surface. A functional study of the stomach revealed a stable reduction of the secretory potential, as well as the normalization of its motor-evacuation function, which contributes to the healing of the ulcer. Due to its low trauma, the operation can be used in surgical practice, especially in cases where organ resection or intervention on the nerve plexus is undesirable.

Diagnosis of perforation from the penetrating ulcer of the posterior wall of the duodenum

2020 ◽  
pp. 38-52
Author(s):  
Elizaveta Vladimirova ◽  
Lyubov Tveritneva ◽  
Era Beresneva ◽  
Olga Alekseyechkina ◽  
Irina Popova ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Inflammatory Process ◽  
Posterior Wall ◽  
Retroperitoneal Space ◽  
Duodenal Wall ◽  
Perforated Duodenal Ulcer ◽  
Perforated Ulcer ◽  
X Ray ◽  
Abdominal Organs ◽  
Penetrating Ulcer

The article is devoted to the problem of emergency surgery for abdominal organs – perforated ulcer of the posterior duodenal wall (duodenum). 140 patients with perforated duodenal ulcer were treated at the N.V. Sklifosovsky Research Institute for Emergency Medicine between 2016 and 2019. Eight patients had perforation from the penetrating ulcer of the posterior duodenal wall. The average age of patients with perforation from the penetrating ulcers in the posterior duodenal wall was 62.25 years (27 to 78 years). Most of the cases were found in men – 87.5%. 7 patients had surgery at the Institute, one was transferred from another medical institution where he underwent surgery. Four patients were discharged with a favorable outcome, and four died. Two of the deceased patients had perforation associated with penetrating duodenal ulcer that was diagnosed during laparotomy; in two other cases, perforation associated with the penetrating ulcer was detected only during autopsy. A feature of perforated gastroduodenal ulcers when they are localized on the posterior wall of the duodenum is poor clinical manifestation, which is associated with the entry of duodenal contents into a limited retroperitoneal space, leading to a significant inflammatory process of retroperitoneal tissue. Complex use of X-ray examination, oesophagogastroduodenoscopy, and CT allows to correctly assess and timely diagnose perforation associated with the penetrating ulcer of the posterior wall of the duodenum into the retroperitoneal space.

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