The results of various organ-preserving operations and resection methods of treatment of 130 patients with complicated giant pyloroduodenal ulcers operated at the City clinical hospital named after S. S. Yudin from 2000 to 2019 were analyzed. Among the patients there were 98 (75.4%) men and 32 (24.6%) women aged 20 to 86 years. The median age was 49.3 years for men and 59.4 years for women. All 130 patients had a combination of two or more complications of peptic ulcer disease. In all cases, there was duodenal stenosis or gastric outlet, mostly compensated or sub compensated. In 9 more patients (6.9%), along with stenosis of the exit section of the stomach, perforation of the anterior wall ulcer in combination with bleeding from the posterior wall ulcer was noted. Penetration into neighboring organs or structures was observed in 73 (56.1%) patients. Hemipylorectomy with transverse pyloroplasty was performed in 34 patients with perforating, 25 patients with bleeding giant pyloroduodenal ulcers. Gastroduodenostomy for Finney was performed in 31 patients. In 26 patients, the operation was combined with combined vagotomy and in 5 patients - with bilateral stem vagotomy. Gastric resection was performed in 22 patients: 13 with perforating ulcers and 9 with bleeding giant pyloroduodenal ulcers. In 19 cases, resections were performed in the volume of two-thirds of the stomach and in 3 cases-pylorobulbar resection. Complications in the early postoperative period were observed in 36 of 130 patients (27.7%), 14 patients died (10.7%). Violation of evacuation from the stomach in the early postoperative period was observed in 51 of 130 patients (39.2%). There were no fatalities among patients who underwent organ-preserving operations with vagotomy.

Keywords:Surgical Treatment; Giant Pyloroduodenal Ulcers; Disease; Ulcers; Combined Complications of Peptic Ulcers, Finney's Operation, Hemipylorectomy, Gastric Resection

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Citation

Citation: Stolarchuk EV., et al. “Comparative Evaluation of the Results of Surgical Treatment of Complicated Giant Pyloroduodenal Ulcers". Acta Scientific Gastrointestinal Disorders 5.5 (2022): 40-46.

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Copyright: © 2022 Stolarchuk EV., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.