Shulyarenko O. Ways of optimization in surgical treatment helicobacterpositive patients with ulcer pyloroduodenal stenosis

Object - Helicobacter pylori-positive ulcer pyloroduodenal stenosis; the purpose - improvement of results of surgical treatment ulcer pyloroduodenal stenosis at Helicobacter pylori-positive patients by development and introduction pathogenetic methods pre- and postoperative therapy, specification of indications to choice of operation method, improvement of this technic in view of stenosis localization and morfofunctional changes; methods - clinical, acid-production function of stomach, motor-evacuational function, presence helicobacter infection, research morfofunctional changes (histologic, histochemic), immunological condition, adenosintriphosphatase activity of muscular tissue of stomach, radiological, statistical; novelty - for the first time it is investigated morfofunctional spatial and immunomorfological characteristics of stenosis zone and around ulcer zone of exit part of stomach and duodenum, there was at first investigated the dynamics of Calcium adenosintriphosphatase activity in muscular tissue of stomach and its connection with motor function of stomach, the efficiency of use of the developed techniques of preoperative preparation for patients with ulcer pyloroduodenal stenosis with use of enteral nutrition by stent made of metal with „memory of the form”, and also under bivisual control, or offered microjejunostomy and also use of offered probe for drain and enteral nutrition in early postoperative period is proved, and the choice of optimum volume of operative intervention depending on a stage of stenosis, polimorbidity and condition weight of patient is determined, and also techniques on intraoperational reduction of expanded stomach without resection is offered; results - use of the developed techniques of preoperative preparation, the advanced method of operative intervention have led to increase in quantity body-preserving operative interventions, to decrease in quantity of direct and remote postoperative complications, increase in quantity of excellent and good results; branch -surgery