New method for suturing «difficult» duodenal stump

Abstract

Ulcerative disease of the stomach and duodenum, remaining a common disease, is successfully treated with modern pharmaceuticals. However, a number of patients develop life-threatening complications that require surgical treatment. Operations include endovideosurgical technologies and traditional laparotomy with organ-preserving techniques and/or classical gastric resection in various versions. When several duodenal ulcer complications are combined, gastric resection in combina- tion or without vagotomy is not an alternative method. The key stage of the operation is the treatment of a «difficult» duodenal stump, and this remains the main problem of ulcer surgery. More than 340 methods of its suturing are known. Operated on 12 men aged 20 to 46 years. Everyone had duodenal ulcer with several complications at the same time. Against the background of peritonitis, 5 people were operated on. All patients underwent gastric resection: Bilrot-I in 2, Bilrot-II in 10. In 7 patients, gastric resection was combined with trunk vagotomy. When treating a «difficult» duodenal stump, the author’s method was used (Russian patent No. 2696656 of 05.08.2019). There were no complications and fatalities. The operation technology is described in detail. In the clinical comparison group of 15 people, with traditional stump processing technology, 2 after the operation had pancreatitis, 1 abscess in the stump due to its insolvency and one patient died from ongoing bleeding from an ulcer in the duodenal stump. Conclusion. The development of new methods for treating duodenal stump based on modern knowledge of pathomorphology processes and the use of new equipment remains relevant.