Verholaz I. Origin,diagnostics and treatment of duodenal and peptic ulcer after selective proximal vagotomy

The thesis is devoted to the problems of increasing effectiveness of treatment of reccurrent and peptic ulcers of anastomosis after SPV. Complex of diagnostic methods was suggested, including immunogistochemical investigation with calculation of gastrin producing cells (G - cells) of mucous membrane of antral stomach portion (MM ASP) that allows to diagnose and define the reason of reccurrence.Incomplete vagotomy and heperplasia of G-cells MM ASP or their combination was established to be the basic reason for recurrence. Data regarding both conservative and surgical treatment was worked out by experience of treatment of 269 patients with recurrent and peptic ulcers after SPV. The choice of operation method was grounded: tube vagotomy with stomach drenage operation is recommended when incomplete vagotomy is reason, antrumectomy - when heperplasia of G-cells MM ASP is the reason, vagotomy together with antrumectomy - when there is the combination of the two reasons.