Chertishchev S. Improvement in technologies of surgical treatment of complicated duodenal ulcer

The thesis is devoted to solving urgent problem - improving the immediate and long-term results of surgical treatment of complicated duodenal ulcer based on the improvement of organ-saving and prevention methods of complications of enteral tube feeding in the early postoperative period.Improved method of duodenoplastic in patients with subpyloric's localization of ulcers, which reduced the frequency of the motor-evacuation disorders at 24.32 % through the use of anatomical features of the gastroduodenal junction and pylorus preservation. Using an improved method for determining the timing of the enteral tube feeding in the early postoperative period allows us to reduce diagnostic errors in determining the timing of the resumption of intestinal absorption to a minimum (sensitivity method 87.36 %, specificity - 81.5 %). Also found that the components of polymer blends for balanced enteral nutrition (milk and soy proteins, poly-and oligosaccharides) stimulate the third (intestinal) phase of gastric secretion. Developed a method of selective blockade of the third (intestinal) phase of gastric secretion during treatment of polymer mixtures balanced, thus reducing the incidence of acute gastrointestinal bleeding by 9.52 % relative to the blockers of histamine H2-receptors. Application of an improved process for preventing intestinal complications (osmotic diarrhea) by applying antiflatulents allowed to reduce the frequency of their development by 30.8 % due to the resumption of membrane digestion.