WHY SHOULD WE ABANDON THE OPERATION OF SIMPLE CLOSURE FOR DUODENAL ULCER COMPLICATED BY PERFORATION?
https://doi.org/10.24884/0042-4625-2018-177-3-41-44
Abstract
The objective is to define the place of the operation of simple closure for perforated duodenal ulcers in the modern stage of the treatment of these patients.
Material and methods. Comparative analysis of 2 groups of patients with perforated duodenal ulcer was made. The 1st group consisted of 40 patients who performed simple closure of perforated ulcers. The 2nd group consisted of 130 patients who fulfilled the excision of the edges of perforated ulcers and Judd pyloroplasty.
Results. It is shown, that the simple closure of perforated ulcer (group 1) leads to statistically significant deterioration of results according to the increasing time from the moment of perforation. Fisher criterion = 0.01784 (p<0.05). The increase of mortality among the patients of the 2nd group also dependent on the duration of the disease and severity of developed peritonitis, but this increase of mortality is not statistically significant. Fisher criterion = 0.11974 (p>0.05).
Conclusion. The operation of the simple closure of perforated duodenal ulcer in the present stage of development of medicine should not be the operation of choice among the most of patients with this pathology.
About the Authors
A. N. VachevRussian Federation
V. K. Koryttsev
Russian Federation
I. V. Antropov
Russian Federation
V. Yu. Shcherbatenko
Russian Federation
Samara
References
1. Afendulov S. A., ZHuravlev G. Yu., Kadirov K. M. Hirurgicheskoe lechenie i reabilitaciya bol’nyh s probodnoj piloroduodenal’noj yazvoj // Aktual’nye voprosy neotlozhnoj hirurgicheskoj gastroehnterologii. Vserossijskaya konferenciya s mezhdunarodnym uchastiem. Gelendzhik, 2010 // Vestnik khirurgicheskoj gastroehnterologii. 2010. № 3. P. 38–38.
2. Gostishchev V. K., Evseev M. A., Golovin R. A. Radikal’nye operativnye vmeshatel’stva v lechenii bol’nyh s perforativnymi gastroduodenal’nymi yazvami // Khirurgiya. 2009. № 3. P. 10–16.
3. Lobankov V. M. Khirurgiya yazvennoj bolezni na rubezhe XXI veka // Khirurgiya. 2005. № 1. P. 58–64.
4. Koskensalo S., Leppaniemi A. Perforated Duodenal Ulcer : Has Anything Changed? // Eur. J. Trauma and Emerg. Surg. 2010. Vol. 36, № 2. Р. 145–150.
5. Wysocki A., Budzynski P., Kulawik J. et al. Changes in the Localization of Perforated Peptic Ulcer and its Relation to Gender and Age of Patients throughout the Last 45 Years // Wld. J. Surg. 2011. Vol. 35, № 4. Р. 811–816.
6. Freston J. W. Management of Peptic Ulcers: Emerging Issues // Wld. J. Surg. 2000. Vol. 24, № 3. Р. 250–255.
7. Kurygin A. A. Vagotomiya v hirurgicheskoj gastroehnterologii: legendy i dejstvitel’nost’ // Vestnik khirurgii. 2006. № 4. P. 83–86.
8. Pancyrev YU. M., Mihalev A. I., Fedorov E. D. Hirurgicheskoe lechenie probodnyh i krovotochashchih gastroduodenal’nyh yazv // Khirurgiya. 2003. № 3. P. 43–49.
9. Rezolyuciya Vserossijskoj konferencii hirurgov «Sovremennye problemy ehkstrennogo i planovogo hirurgicheskogo lecheniya bol’nyh yazvennoj bolezn’yu zheludka i dvenadcatiperstnoj kishki». Saratov, 25–26 sentyabrya 2003 g. // Khirurgiya. 2004. № 3. P. 86–87.
10. Ermolov A. S., Gulyaev P. A., Karnaushenko P. V. i dr. EHkstrennaya laparoskopiya pri os-tryh hirurgicheskih zabolevaniyah organov bryushnoj polosti // Materialy XI s’ezda hirurgov Rossijskoj Federacii. Volgograd, 2011. P. 114.
11. Majstrenko N. A., Romanenko P. N., Sidorchuk P. A. i dr. Obosnovanie ehndovideohi-rurgicheskogo lecheniya perforativnyh duodenal’nyh yazv // Al’manah instituta khirurgii im. A. V. Vishnevskogo. 2012. № 7 (1). P. 254– 255.
12. Horobryh T. V. V prodolzhenie diskussii o stat’e prof. A. I. CHernookova i soavt. «Sovremennyj vzglyad na anatomiyu bluzhdayushchih nervov i tekhniku vagotomii» // Vestnik khirurgicheskoj gastroehnterologii. 2009. № 2. P. 70–71.
13. Vachev A. N., Kozlov A. A., Suhachev P. A. et al. Morfologicheskoe obosnovanie ob»ema issekaemoj tkani pri operacii po povodu perforativnoj yazvy dvenadcatiperstnoj kishki // Khirurgiya. 2011. № 2. P. 21–24.
Review
For citations:
Vachev A.N., Koryttsev V.K., Antropov I.V., Shcherbatenko V.Yu. WHY SHOULD WE ABANDON THE OPERATION OF SIMPLE CLOSURE FOR DUODENAL ULCER COMPLICATED BY PERFORATION? Grekov's Bulletin of Surgery. 2018;177(3):41-44. (In Russ.) https://doi.org/10.24884/0042-4625-2018-177-3-41-44