[Hemipylorectomy with transverse pyloroplasty and vagotomy in perforating and bleeding ulcers of the pyloric canal]. / Gemipiloréktomiia s poperechnoi piloroplastikoi i vagotomiei pri probodnykh i krovotochashchikh iazvakh piloricheskogo kanala.

Hemipylorectomy with transverse pyloroplasty and vagotomy was made in 922 patients with perforating and bleeding ulcers of pyloric canal. 510 of them had perforation of ulcer, 412--ulcer bleeding. In all the cases ulcer was excised together with anterior semicircle of the pylorus, the defect was sutured transversely. Hemipylorectomy with transverse pyloroplasty was combined with (anterior selective proximal serous-muscular and posterior trunkal) vagotomy. Postoperative lethality in perforation of ulcer was 4.8%, in bleeding--8.2%. From 1 year to 10 years after operation good functional results were achieved in the majority of the patients. This variant of organsaving operation is optimal in complicated ulcers of pyloric canal.

[Comparative results of surgical treatment for perforating and bleeding pyloroduodenal ulcers]. / Sravnitel'nye rezul'taty khirurgicheskogo lecheniia probodnykh i krovotochashchikh piloroduodenal'nykh iazv.

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.

[Evaluation of the gastric outlet function of normal and operated stomach using ultrasound]. / Otsenka funktsii vykhodnogo otdela normal'nogo i operirovanogo zheludka s pomoshch'iu ul'trazvuka.

The functional condition of the gastric outlet was studied by ultrasound in 25 individuals (the comparison group) and in 37 patients after organ-preserving operations for complicated pyloroduodenal ulcers. The diameter of the gastric outlet and the pylorus, the length of the pyloric canal were recorded during the examination and the presence or absence of duodenogastric reflux was noted. A duodenogastric reflux was found in 48% of persons of the comparison group, in 25% of patients after Judd's pyloroplasty and all patients after Finney's pyloroplasty. The data obtained provide evidence that the functional results are better in pylorus-preserving and pylorus-saving operations that in pylorus destroying operations which lead to loss of the obturation function of the pylorus.