Vakulenko V. Differentiated approach to the choice of the operative method for perforative duodenal ulcer patients in dependence on perforation period

The dissertation is devoted to the improvement of efficiency of surgical treatment in perforative duodenal ulcer patient. In control group patients (n=106) intervented by radical operations in the term of 6 hours since the perforative moment, and longer 6 hours - the only suture of duodenal ulcer. The unsatisfactory results in further period were 32,9 %. For choice of adequate operative intervention in basic group (n=60) scientifically based additions to the preoperative investigation protocol (FEGDS, computary pH-metry in real time, express definition Hp and MAM generation, mucose stomach and duodenal biopsy) on which base functionally conditioned algorithime distrebution of patients into three principal groups was worked out. In the first one of them ulcer sustrate resection and surgical vagotomy (duodenoplasty and SPV) was fulfilled, in the second one - the only duodenoplasty with further directed "medicomentose" vagotomy upon gastroenterologist, in the third one - the only suture of perforative hole in duodenal ulcer and prolongued "medicomentose" vagotomy (on data). It is showed thet under such approach long positive results (excellent, good) in basic group were 83,9 %.