Solutions to some complicated situations in the surgery of acute complications of peptic ulcer
DOI:
https://doi.org/10.11603/2414-4533.2017.3.7938Keywords:
peptic ulcer, Zollinger-Ellison syndrome, gastroplasty, duodenostomy.Abstract
The aim of the work: to introduce to a wide range of surgeons the best methods developed so far of a gastroplasty and duodenostomy formation.
Materials and Methods. 16 men aged 47 to 72 years old. Perforation of the giant stomach ulcer occurred in 11 cases, bleeding from ulcers – in the rest. The diffuse peritonitis is identified in 8 (72.72 %) cases, total – in 3 (27.28 %). Endoscopic and conservative treatment were ineffective for patients with bleeding. An excision of the ulcer was done to 15 patients, and the diameter of the defect was 8–14 cm afterwards. Due to the perforation of the gastric ulcer to the patient with the Zollinger-Ellison syndrome, the subtotal gastrectomy was carried out. The gastroplasty after the ulcer incision was carried out using the elaborated procedure, which is applied through slanting direction suturing of a defect.
Results and Discussion. The use of such gastroplasty method leads to a restoration of the usual form of the stomach. In 1-2 years after the operation, 9 patients were examined. None of them had any display of cascade deformation of the stomach. The patient with the Zollinger-Ellison syndrome, due to the second time perforations of the duodenum stump ulcers, the duodenostomy developed method was used, when a cut round ligament of the liver is fixed around the stump and a tube. No insolvency of duodenostomy was found. So, the elaborated methods can be used in corresponding complicated intraoperational situations.
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