[Surgical treatment of patients with recurrent postoperative complicated duodenal ulcers].

Complex examination and surgical treatment, using various organ-preserving operations, was done in 54 patients, suffering recurrent postoperative complicated duodenal ulcers. Performance of pathogenetically unsatisfactory volume of the first operation, technical faults, absence of pathogenetically substantiated therapy in postoperative period had constituted the causes of unsatisfactory results of the first operation. Reconstructive organ preserving intervention, consisting of impact on all chains of recurrent ulcerogenesis, with subsequent pathogenetically substantiated rehabilitation of patients, were consider the operation of choice.

[Antihelicobacteric therapy for the patients with recurrent complicated postoperative gastroduodenal ulcer: indications, principles of conduction, efficacy].

After performance of organ preserving operations the cytotoxic stamms of H. pylori were revealed in 47 (94%) patients with recurrent ulcer. after gastric resection--in 27 (58.6%). The conduction of antihelicobacteric therapy is indicated to all the patients, in whom recurrent ulcer had occurred after organ preserving operations performance, its indication after gastric resection performance must be individual, after the patient examination succession. Application of a combined preparation, consisting of 20 mg of omeprazol, 500 mg of clarithromycin, 1000 mg amoxicillin, in a standard dosage of 3 tablets twice a day during 7 days have permitted to achieve the H. pylori cytotoxic stamms eradication in 94.2% of the patients. The preparation is well endured by the patients, the adverse reactions are minimal, temporary, their occurrence does not necessitate the preparation abolition.

[Duodenogastric reflux in patients with recurrent postoperative complicated duodenal ulcers].

Duodenogastric reflux (DGR) was revealed in 52.6% patients, suffering recurrent postoperative complicated duodenal ulcers (RPOCDU). Pylorodestructive operations performance, pyloric involvement into ulcerative infiltrate and absence of chronic duodenal impassability (CHDI) correction during the first operation done had constituted the DGR occurrence causes. While establishing the indications for elective operation performance as well as choosing the surgical method of the RPOCDU treatment it is necessary to take into account the presence and severity degree of DGR. Surgical treatment of DGR must obligatory include not only the pyloric preservation and strenghtening, but the CHDI correction as well. Selective periarterial sympathectomy of duodenum constitutes an effective method, improving her tone without pyloric innervations disturbing.

[Application of the proton pump inhibitors in treatment of an acute gastro-intestinal bleeding of the ulcer etiology].

The results of treatment of 53 patients, suffering an acute gastro-intestinal bleeding of the ulcer etiology are adduced. The proton pump inhibitor Omez infusion have promoted the improvement of the patients treatment results.

[Comparative estimation of the prognosis methods for an early recurrency of hemorrhage of ulcerative genesis]. / Sravnitelnaia otsenka metodov prognozirovaniia rannego retsidiva krovotecheniia iazvennogo geneza.

There were revealed the occurrence risk factors for an early recurrence of hemorrhage of ulcer etiology, the method of mathematical prognosis was suggested with 78.8% authenticity. The programm of computeric prognosis, basing on "neuronic nets" with 91% authenticity was elaborated. It was established that computeric prognosis is more authentic and perspective method in comparison with mathematic one.