Klokol D. Application of pyloruspreserving and pylorusrenewing operations in the complex of surgical treatment of perforated pyloric and duodenal ulcers

Object-peptic ulcer disease, complicated by perforation; the purpose - to improve early and late results of surgical treatment of patients with perforated duodenal peptic ulcers by elaboration and application of methods of pyloro-duodenal correction counting on local immunity of stomach and duodenum and Helicobacter pylori contamination; methods - common - clinical, laboratory, X-ray, tool, statistical; the novelty - The criteria for choosing of particular pylorus-preserving operation depending on size and location of ulcer is established. New method of pylorus-duodenoplasty is developed. The comparative analysis of early and late results after pylorus-destructive and pylorus-preserving operations is given, expediency of application of pylorus-preserving and pylorus-renewing operations is scientifically substantiated and proved. Possibility of application and expediency of different methods of duodenoplasty is proved. Clinical effectiveness of evaluation of Helicobacter pylori contamination at patients with perforated peptic ulcers and it's value in treatment's tactics is established; results-Application of pylorus-preserving and pylorus-renewing operations allowed to reduce in early post-operative period frequency gastrostasis in 2.1 times, active gastritis in 3.7 times, duodenogastral reflux in 4.6 times. In late post-operative period motority and evacuation function of stomach was restored in 75.3% of cases, duodenogastral reflux was registered only in 4.5%, in control group - in 46.7%. аctive gastritis has occurred in 5 times less then after traditional operations. Complete Helicobacter pylori eradication was achieved in 77.5% of cases, comparatively to 22.8% in control group. Duration of hospitalization was reduced on 2-3 days. Fine and good results were achieved in 91%, that is in 1.9 times more then after traditional operationsIntroduced - in medical practice, in educational process; branch - medicine.