Ioffe I. Complicated gastro-duodenal ulcers (etiology, pathogenesis, treatment)

The thesis is dedicated to the improvement of surgical treatment in patients with combined gastro-duodenal ulcers on the basement of study of pathogenetic links, unification of indications to the operative treatment and creation of new surgical methods. It is shown that long-lasting contact of gastric and duodenal mucosa with ephedrine increased the frequency of combined ulcers, induced the glandular cellular hyperplasia and intestinal metaplasia, and inhibited the development of glandular atrophy. The state of micro-circulation, metabolic and immune status of Ukrainian and Yemen patients with isolated and combined ulcers is studied for the first time. The clinical efficacy of original surgical method in treatment of patients with combined gastro-duodenal ulcers and long-lasting ephedrine usage in anamnesis is proved. The pathogenetic efficacy of glutargine, erbisol and thymogen in surgical treatment of patients with isolated and combined gastro-duodenal ulcers is studied for the first time. The influence of glutargine, erbisol and thymogen on immune and metabolic status of patients who underwent the surgical treatment is studied.