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 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 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 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%).

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.

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

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 Surgical Treatment of Rectal Prolaps in 83 Year Old Patient. A Case Report.

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Nuhi Arslani ◽  
Basri Lenjani
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Abdominal Surgery ◽  
Rectal Prolapse ◽  
Female Patient ◽  
Surgical Approach ◽  
Careful Consideration ◽  
Optimal Treatment ◽  
Favorable Outcome ◽  
Altemeier Procedure

Background: Prolapse of the rectum is an uncommon problem. It is defined as a protrusion of the rectum through the anus and can cause disability. There is no concensus in literature which surgical approach is the most appropriate. The aim of our case report is to share our experiance and results of the Altemeier procedure.  Case report: 83 years old female patient was admited to the department for general and abdominal surgery. She was diagnosed with rectal prolapse, which could not be reponated. She felt pain and was incontinent.  Results: We decided that optimal treatment for the patient was operation. Altemeier approach was performed. In our opinion, we achieved a favorable outcome.  Conclusion: As stated above there is no clear concensus on which treatment is the most appropriate for rectal prolaps. In our case after careful consideration, we decided that the Altemeier approach was the best solution for the patient.   

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.

LAPAROSCOPIC REPAIR OF PERFORATED DUODENAL ULCER PATCH VERSUS CONVENTIONAL SURGERY

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Dr. Anil Kumar Saxena ◽  
Dr. Devi Das Verma
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Repair ◽  
Open Repair ◽  
Wound Dehiscence ◽  
Duodenal Perforation ◽  
Perforated Duodenal Ulcer ◽  
Conventional Surgery ◽  
Duodenal Ulcers ◽  
Duration Of Operation ◽  
Repair Group

Introduction: For many surgeries for duodenal ulcer Laparoscopic repair has become gold standard for many elective procedures such as ant reflux procedures, laparoscopic cholecystectomy and in colorectal surgery. Although in the emergency setting such as in the management of perforated duodenal ulcer Laparoscopic repair has been slow and limited. Since 1990, for the treatment of perforated peptic ulcer Laparoscopic repair has been used which has been widely accepted as an effective method. Duodenal ulcer is defined as a peptic ulcer which develops in the first part of the small intestine called duodenum and usually present as a perforation of acute abdomen. In perforated duodenal symptoms as severe and sudden onset abdominal pain that is worse in right upper quadrant and epigastrium and usually followed by nausea and vomiting. In this situation there is rapid generalization of pain and in examination shows peritonitis with lack of bowel sounds. Aim: The main objective of this study is to evaluate outcome of laparoscopic surgery in comparison with conventional surgery. Material and methods: All the patients with clinically diagnosed with perforated duodenal ulcers presenting within 24 hours of symptoms and undergoing surgery were included during the study period. Total 50 patients were included with age group 15-65 years. All the patients with perforated duodenal ulcers were included which go through either conventional open or laparoscopic without omental patch repair. Result: Total 50 patients were included in these studies which were divided into two group with 25 patients in each group as laparoscopic duodenal perforation repair group and conventional open repair group. Mean duration of operation (in minutes) was 105.4±10.4 in laparoscopic duodenal perforation repair group whereas mean duration of operation (in minutes) was 67.3±8.6 in conventional open repair group. Mean duration of number of doses of analgesics required in laparoscopic group and conventional open group as 9.5±1.7 and 17.2± 3.1 respectively. Out of 25 patients in each group of laparoscopic duodenal perforation repair group and the conventional open repair group the outcome were noted with their post operative complication as shown in table no 5 below.   In Post-operative complications 21(84%) patients in laparoscopic duodenal perforation repair group and 14(56%) patients in conventional open repair group had no complications. 4 (16%) patients in the laparoscopic duodenal perforation repair group and 2(8%) patients in conventional open repair group showed Post-operative complications as chest infection. In the conventional open repair group  patients present with wound dehiscence and wound infection and Wound dehiscence and chest infection were 4(16%) and 5(20%) respectively whereas nil in Laparoscopic duodenal perforation repair group. Conclusion: Duodenal ulcer perforation is a life-threatening emergency which required urgent management for the patients. Due to the advance in duodenal ulcer perforation closure by laparoscopy it becomes popular and favorite choice. With certain criteria, laparoscopic closure of perforated duodenal ulcer is safe and effective though it was associated with longer operating time and had no impact on the outcome. Hence laparoscopic closure was better in comparison to open repair for the earlier returns to normal daily activities. Keywords:  Duodenal ulcer, Laparoscopic repair, Post-operative analgesia, conventional surgery

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