Sytnick A. The choice of individual method of surgical treatment in patients with perforated gastroduodenal ulcer and peritonitis.

Object of the study: Результаты исследования внедрены в практику работы Центральной городской клинической больницы г. Киева, Львовской коммунальной городской клинической больницы скорой медицинской помощи и Cумской городской клинической больницы №5, использованы в учебном процессе на кафедре госпитальной и факультетской хирургии Сумского государственного университета. Purpose of the study: To improve the results of surgical treatment of the patients with perforated gastroduodenal ul-cer complicated with peritonitis by means of optimizing therapeutic and rehabilitation tactics Methods and equipment: Survey radiography of the ab-dominal cavity, fibrogastroduodenoscopy, laparocentesis, laparoscopy, contrast x-ray study of the stomach with barium meal, intragastric measurement of pH, laboratory and immunological study, electron microscopy of the gastric cells and those of the pyloric zone, statistical evaluation of the findings. Theoretical and practical results: Optimal volumes of surgical interventioninpatients with perforated gastroduodenal ulcer complicated with peritonitis were suggested with the account of the totality of prognostic factors of lethality. Methods of prevention of post-operative complications with the account of the pathogenetic factors were suggested Novelty: For the first time, a convenient rating of prognostic factors influencing lethality in perforated gastroduodenal ulcer with the account of the character of peritonitis was done, groups of surgical risk were formed, objective choice of optimal volume of the surgery was substantiated. The rating system was used to study and evaluate prognostic factors of insufficient outcome of the treatment after various operations. Depending on the surgery technique, surgical risk group and group of prognosis of long-term results of the treatment, the measures of patient rehabilitation were worked out. A technique for duedenoplasty in perforated duodenal ulcers as well as technique for stomach and duodenum suturing were suggested. Degree of introduction: The results of the research were introduced into the practice of Central City Clinical Hospital (Kyiv), Lviv Communal City Clinical Hospital for Urgent Medical Aid and Sumy City Clinical Hospital No. 5, they are used in teaching process at Surgery Department of Sumy State University. Field of application: Medicine, surgery.