Dotsenko V. Evaluation of the results and quality of life of the patients with perforated gastroduodenal ulcers with the considerations of surgical technique

The aim of the work is to improve the results of surgical treatment of patients with perforated gastroduodenal ulcers based on the ground of method of operation and taking into account prognosticated life quality of the patients. The analysis of intraoperative material has shown that chronic ulcer was present in all analyzed cases, and the signs of chronic inflammation prove this point. It was established that in remote terms the mucous membrane of the pyloroantral part of the stomach had the morphological peculiarities, typical for chronic moderately expressed nonactive nonassociated with Helicobacter pylori atrophic gastritis with focci of complete intestinal metaplasia; for the body of the stomach most spread was the condition which corresponded to the morphological picture of surface and initial nonassociated with Helicobacter pylori atrophic gastritis; in the duodenal mucous membrane was determined more frequently. Division of types of chronic gastritis and duodenitis, determined by morphological examination of biopsies of the patients operated with vagotomy and without it, was equal. These data should be taken into account during the planning of postoperative conservative therapy. By the analysis of life quality of the patients, operated in connection with perforated gastroduodenal ulcer with vagotomy, and without it, during 2 years and a more remote period a statistically authentic difference between the patient's complaints wasn't determined. Necessity in limitation of everyday vital activity, public and private life is equal in both patients groups. At surgical treatment of the patients with perforated gastroduodenal ulcers the excision of ulcer with following pyloroplasty and medicinal correcting therapy should be performed. In the postoperative period prophylactic medical examination, including fibergastroguodenoscopy and biopsy should be carried out in order to determine the degree of morphological changes of the mucous membrane.