ABSTRACT
Actual questions of diagnostics and treatment of 776 patients with perforated gastroduodenal ulcers are discussed. The most informative method of the diagnosis, particularly covered perforation, is laparoscopy. Decision on the operation must be individually grounded. Radical operations were performed in 599 patients with 2% postoperative lethality. Lethality after suturing of the perforation was 10.3%, after resection operations--4.1%, after suturing the perforation in combination with selective proximal vagotomy--0.3%.
Subject(s)
Decision Making , Duodenal Ulcer/complications , Gastrectomy/methods , Laparoscopy/methods , Peptic Ulcer Perforation/surgery , Stomach Ulcer/complications , Vagotomy/methods , Adolescent , Adult , Aged , Aged, 80 and over , Duodenal Ulcer/surgery , Follow-Up Studies , Humans , Middle Aged , Retrospective Studies , Stomach Ulcer/surgery , Treatment Outcome , Young AdultABSTRACT
4212 patients with ulcer gastrointestinal bleedings were treated during 1990-2007 years. 364 patients had gastric ulcers, other patients had duodenal ulcers. 1819 patients (43.2%) were operated. 418 patients (23%) were operated due to ineffective endoscopic hemostasis and recurrent bleedings. 409 patients (22.5%) underwent urgent operations because of risk for recurrent bleeding. Elective operations were carried out to 1358 patients (74.7%). Postoperative lethality amounted 5.8% including 19.1% lethality after emergency operations, 4.2% lethality - after urgent operations and 0.8% lethality - after delayed operations. The general hospital lethality amounted 3.3%. Lethality can be decreased by extension of indications for urgent operations, preventing recurrent bleedings.
Subject(s)
Duodenal Ulcer/surgery , Hemostasis, Endoscopic/methods , Peptic Ulcer Hemorrhage/surgery , Stomach Ulcer/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Cause of Death/trends , Duodenal Ulcer/mortality , Endoscopy, Gastrointestinal , Humans , Middle Aged , Peptic Ulcer Hemorrhage/mortality , Retrospective Studies , Russia/epidemiology , Stomach Ulcer/mortality , Survival Rate/trends , Treatment Outcome , Young AdultABSTRACT
The authors made an analysis of using a one-layer uninterrupted suture with a synthetic absorbable thread in forming gastrointestinal, intestinal, duodenojejunal and pancreatojejunal anastomoses. The operation technique and early complications are described showing advantages of the one-layer uninterrupted suture with a synthetic thread.
