Affiliation:
1. State Institution “Institute of Gastroenterology” of the Ministry of Health and Social Development of the Republic of Tajikistan
Abstract
Aim. To improve the surgical treatment tactics of gastroduodenal ulcerous bleeding combined with pyloroduodenal stenosis.Material and methods. Results of diagnostics and surgical treatment of 105 patients with DUD, divided into two groups were analyzed: the first - 54 patients, in which individualized tactics with maximum use of modern endo- and pharmacological hemostasis was used, mainly planned operations were executed; the second - 51 patients, in which active surgical tactics without endohemostasis was used, mainly “traditional” variants of gastric resection were used.Results. In case of active surgical tactics the number of urgent operations made up 29,4%, delayed - 54,9%, planned operations - 15,7%. The use of resection (76,4%) and palliative (19,6%) operations was one of the causes of a high frequency of postoperative complications (37,2%) and lethality rate (13,7%). The use of modern endo- and pharmacological hemostasis techniques contributed to the efficacy of treatment, a decrease in urgent (11,0%) and delayed (9,2%) operations, and an increase in elective operations (79,8%), which promoted the decrease of postoperative complications (9,2%) and absence of lethality.Conclusion. In DUD the tactics based on endo- and pharmacological hemostasis contributes to a decrease of operation activity by urgent and delayed indications, transfer of the situation to the category of the planned operations that promotes the decrease in the frequency of postoperative complications and lethality.
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