Ценность противоязвенной терапии с иссечением перфоративных пилородуденальных язв с пилородуоденопластикой и оценкой результатов эндокскопического метода исследования в отдаленном периоде

Abstract

In order to reduce recurrence after surgical interventions in order to increase the effectiveness of surgical treatment, in recent years we have been using excision of a perforated pyloroduodenal ulcer with pyloroduodenoplasty, and in the postoperative period we began to use antiulcer therapy. The purpose of the work: to evaluate the results of the endoscopic method of research and confirm the value of antiulcer therapy after surgical interventions performed in the long term for perforated pyloroduodenal ulcers. Material and methods: 314 patients were under observation from 2014 to 2020. 3 groups of patients: the first group of 103 patients who underwent suturing of a perforated pyloroduodenal ulcer. The second group of 105 patients — excision of a perforated pyloroduodenal ulcer with pyloroduodenoplasty, and in the third group 106 patients — excision of a perforated pyloroduodenal ulcer with pyloroduodenoplasty with antiulcer therapy, receiving antiulcer therapy. Results: The results of endoscopic examination of the first group of patients, ulcer recurrence in 17 (16.5%), erosion of the pyloroduodenal zone in 23 (22.3%), stenosis in the area of suturing in 11 (10.6%) and less often reflux gastritis and esophageal hernia were detected. apertures of the diaphragm, which before endoscopic examination were recognized as a recurrence of the ulcer. The identified changes were indications for reoperation in 28 patients. Analysis of the results of patients in the third group during endoscopic examination in 3 patients revealed gastroduodenitis and 4 patients there was a combination of these complications, therefore, the disease was detected in 5 patients, which amounted to 4.8%. In case of a pyloroduodenal ulcer complicated by perforation, excision of the ulcer with pyloroduodenoplasty followed by antiulcer therapy and further monitoring by a family doctor and endoscopic examination in the long term should be recognized as the method of choice.