Novosti
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Year 2020 Vol. 28 No 1
EXCHANGE OF EXPERIENCE
A.F. CHERNOUSOV, T.V. KHOROBRYH, M.V. ZUBAREVA, V.I. KOROTKIY, N.M. ABDULKHAKIMOV, R.E. SALIKHOV
RESULTS OF THE REPEATED STOMACH RESECTION BY BILLROTH I AND ORGAN-PRESERVING OPERATIONS IN THE TREATMENT OF THE DUODENUM ULCER
I.M. Sechenov First Moscow State Medical University, Moscow
The Russian Federation,
N.N.Burdenko Сlinic of faculty surgery, Department of faculty surgery №1
The Russian Federation
Objective. To study of the results of repeated gastric resection by Billroth I and organ-preserving operations in the treatment of duodenal ulcer complicated by pyloroduodenal stenosis in patients who underwent surgery to create a transverse gastroduodenoanastomosis.
Methods. From 2006 to 2017, 96 patients were examined and treated in the Clinic of the faculty surgery named after N. N. Burdenko. 54 patients underwent the reconstructive surgery with the creation of Billroth I anastomosis, 42 patients underwent the organ-preserving surgery with the imposition of transverse gastroduodenoanastomosis, esophagomyotomy and fundoplication for pyloroduodenal stenosis (19 – the laparoscopic operation).
Results. Early postoperative complications after the reconstructive surgery with the creation of Billroth I anastomosis were the following: 8 patients – dyspepsia, acute pancreatitis aggravation and asthenoneurotic syndrome in 7 patients. After organ-preserving surgeries, 5 patients had weakly expressed gastrostasis in the early postoperative period, 2 patients – reactive pancreatitis. All of them were stopped during hospitalization; the postoperative period was not affected by them.
In the late postoperative period (6 months – 5 years) the signs of the postgastrectomy syndromes and recurrence of ulcers were not revealed. Regression of the main symptoms was noted in the vast majority of patients. According to the SF-36 there are similar indicators with general population.
Conclusions. Patients with Billroth II anastomosis and who developed the postgastrectomy syndromes should have the repeated surgery: reconstruction to Billroth I anastomosis with the restoration of the passage of the duodenum. Routine surgical treatment of a complicated form of gastric ulcer (pyloroduodenal stenosis) includes selective proximal vagotomy with the imposition of transverse gastroduodenoanastomosis and circular esophagomyotomy with the formation of fundoplication cuff.
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119435, Russian Federation,
Moscow, B. Pirogovskaya Str., 6-1,
I.M. Sechenov First Moscow
State Medical University,
Clinic of the Faculty Surgery
Named after N. N. Burdenko,
Department of Faculty Surgery №1.
Tel. +7 906 068-38-12,
e-mail: dr.korotkiy@mail.ru,
Valentin I. Korotkiy
Chernousov Alexander F., MD, Professor, Academician of RAS, Honored Scientist of the Russian Federation, Head of the Department of Faculty Surgery No1, Clinic of the Faculty Surgery named after N. N. Burdenko, I.M.Sechenov First Moscow State Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0001-8792-1459
Khorobryh Tatiana V., MD, Professor of the Department of Faculty Surgery No1, Clinic of the Faculty Surgery named after N. N. Burdenko, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0001-5769-5091
Zubareva Mariya V., Surgeon, Clinic of the Faculty Surgery named after N. N. Burdenko, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0002-7050-9393
Korotkiy Valentin I., Surgeon, Post-Graduate Student of the Department of Faculty Surgery No1, Clinic of the Faculty Surgerynamed after N. N. Burdenko, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0002-1359-5379
Abdulkhakimov Nuriddin M., Surgeon, Assistant of the Department of Faculty Surgery No1, Clinic of the Faculty Surgerynamed after N.N. Burdenko, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0002-8324-2376
Salikhov Rashad E., 6-Year Student, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
https://orcid.org/0000-0003-1090-2123
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