RESUMO
Results of treatment of 1309 patients with perforated and bleeding pyloroduodenal ulcers for 20-years period have been analysed. Resection of the stomach performed in 85 cases resulted in high postoperative lethality which made up in bleeding ulcers 14.8%. Drainage operations of the stomach with excision or suturing of ulcer combined with bilateral truncal vagotomy was performed in 60 patients, postoperative lethality rate being 8.4%. 128 patients underwent selective proximal vagotomy together with pyloro- and duodenoplasty, lethality rate being 1.6%. Combined vagotomy (posterior truncal and anterior sero-muscular) with excision of ulcer, transversal pyloroplasty and duodenoplasty was carried out in 1036 patients (postoperative lethality--2.4%). Excellent and good functional results were achieved in 79.6% of the patients.
Assuntos
Úlcera Duodenal/cirurgia , Gastrectomia , Úlcera Péptica Hemorrágica/cirurgia , Úlcera Péptica Perfurada/cirurgia , Vagotomia Gástrica Proximal , Drenagem , Úlcera Duodenal/complicações , Feminino , Seguimentos , Humanos , Masculino , Úlcera Péptica Hemorrágica/complicações , Úlcera Péptica Perfurada/complicações , Antro Pilórico , Estudos Retrospectivos , Técnicas de Sutura , Resultado do TratamentoRESUMO
Anterior seromyotomy of the body and fundus of the stomach was combined with posterior truncal vagotomy and excision of the ulcer in 23 patients with gastric ulcer complicated by bleeding or perforation. Seventeen patients had chronic ulcers of the body of the stomach (type I), 3 patients had concurrent ulcers (type II), and 3 more patients had acute ulcers of the body of the stomach. Operation was undertaken for active bleeding from the ulcer in 20 patients and for perforating ulcer in 3 patients. One patient died. Mild disorders of evacuation of an aqueous barium sulfate suspension from the stomach were noted in 4 patients.