[Transabdominal ultrtasonic investigation of the upper parts of the gastro-intestinal tract in diagnostics of ulcer disease and decision on the strategy before and after surgery].

The authors present an analysis of results of the diagnostics and treatment of 293 patients admitted to the Alexandrovskaya hospital of St. Petersburg in 1995-2005 for gastroduodenal ulcer, including 202 patients after operative treatment. The morpho-functional state of the upper parts of the gastro-intestinal tract was assessed by the method of transabdominal sonography of the stomach and duodenum with a convection transducer 5 MHz in on-line regimen. The informative value of the method corresponds to the reference diagnostics method, sensitivity of the method was 91%, specificity--95%. The ultrasound investigation of the stomach and duodenum is a highly efficient method of diagnostics of the morpho-functional state of the gastro-duodenal system giving a reliable interpretation of the local morphological and functional changes, ulcer disease included, corresponding to the efficiency of the reference diagnostics methods. The sonography allows a dynamic control of the treatment process, assessment of the alterations after surgery on the stomach and duodenum and decision on the exact surgical strategy.

[Resection with pyloric retention as a method for prophylaxis of dumping syndrome].

The aim of the study was the evaluation of efficacy of the resection with pyloric retention proposed by the authors as a method for prevention of post gastroresectional damping syndrome in patients with ulcers. Resection with pyloric retention is performed in six modifications of three basic methods of resections. We have the experience of using this approach in 712 clinical cases. Among them 237 were women and 475 were men 19-75 years of age. It was shown that resection with pyloric retention provides rhythmic evacuation and prevents development of damping syndrome and duodenal reflux. It was found that the main reasons of the development of postgastroresectional syndromes include wide-area mobilization of the stomach and resection of the small curvature, which induce insufficiency of cardia, atony, chronic disturbances of the duodenal passing. Due to the retention of pyloric function damping syndrome have been developed only in 3 patients. In all these cases the syndrome was mild. It may be concluded that gastric resection with pyloric retention represents the most "physiological" intervention and has many advantages in comparison with other methods.