Volume 03 Issue 05-2023
96
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
05
P
AGES
:
96-99
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
Decompression methods can be widely used to prevent early postoperative complications, preventing the
development of hypertension and stasis in the early postoperative period, creating functional rest in the surgical
intervention area.
KEYWORDS
Duodenum, gastroduodenoanastomosis, decompression, probe, treatment.
INTRODUCTION
Duodenal ulcer (DU) is one of the most common
gastroenterological diseases, often accompanied by
life-threatening complications such as bleeding,
perforation, etc. [1, 2].
Surgical treatment for complicated DU is now
generally recognized, and many surgeons prefer and
promote gastric resection (GR) as the most radical
operation [3, 4].
Research Article
SURGICAL TREATMENT AND PREVENTION OF GASTRIC AND DUODENAL
ULCERS
Submission Date:
May 21, 2023,
Accepted Date:
May 26, 2023,
Published Date:
May 31, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue05-14
A.S.Pakirdinov
Andijan State Medical Institute, Uzbekistan
M.M.Madazimov
Andijan State Medical Institute, Uzbekistan
A.T. Nuditdinov
Andijan State Medical Institute, Uzbekistan
B.J. Rahmonov
Andijan State Medical Institute, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 05-2023
97
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
05
P
AGES
:
96-99
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
MАTЕRIАLS АND MЕTHОDS
An analysis of the literature shows that the main
disadvantages of traditional GR are high postoperative
mortality, which still reaches 5
–
12.9% [5, 6], removal of
pyloric sphincter and disturbances in portioned food
evacuation, which are common in 18
–
58.6% of patients
[2].
The most frequent early complications of gastric
surgery include motor-evacuation disorders of the
operated stomach and intestines, such as anastomosis,
gastrostasis, pancreatitis, etc. However, there is still no
unified idea about their nature and patterns of
development [5].
Considering that the frequency of these complications
is still at a relatively high level, this problem is of
particular urgency and relevance at the present time.
However, many aspects of these complications from
the standpoint of prevention have not yet been
studied with sufficient completeness, both in domestic
and foreign literature [5].
For the period from 2017 to 2022, 277 patients were
operated on for duodenal ulcer at the Department of
Surgical Diseases of the State Medical Institute. All
patients underwent various options for primary and
repeated surgical interventions.
RЕSULTS АND DISСUSSIОN
The nature of primary and repeated surgical
interventions performed in patients with peptic ulcer
disease, in which various decompression techniques
were used, turned out to be as follows: out of the total
number, the largest part was GR operations with
preservation of the duodenal passage in 256 or 92.4%
of patients. Of these, GR according to Billroth I in the
modification of Gaberer-161 (58.1%), and GR according
to Billroth I in the modification of Gaberer-Fineya-95
(34.3%).
Operations aimed at exclusion of the 12th duodenum
from the act of digestion amounted to 5.1% (14
patients), that is, significantly less than in the group of
patients with preservation of the duodenal passage.
Reconstructive GR according to Roux-Ibadov in its
various variants was performed in 7 patients or 2.5% of
cases.
We made the distribution of patients according to the
age classification adopted by WHO (1963), according to
this classification, four age groups were identified.
Thus, the largest number of patients 146 (52.7%) was in
the second age group, and 35 (12.6%) patients were in
the first age group, in the third age group there were
75 (27.1%) and only 21 ( 7.6%) - in the fourth age group.
Of the examined patients: men - 213 (76.9%), and
women
–
64 (23%).
It should be noted that in our observations, the bulk of
the patients were young and middle-aged, i.e. the most
Volume 03 Issue 05-2023
98
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
05
P
AGES
:
96-99
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
able-bodied age of the population. It is at this age that
the choice of the correct primary method of surgical
intervention
for
duodenal
ulcer
is
decided
ambiguously.
In order to obtain the most complete and detailed idea
of the localization and prevalence of the pathological
process, in addition to a thorough study of the
anamnesis, a detailed clarification of clinical
symptomatology, and general clinical tests, the
patients underwent a comprehensive examination.
The complex of preoperative examination included
both conventional and special research methods, such
as the study of the motor-evacuation function of the
stomach or its stump by contrast fluoroscopy with
computer support; endoscopic examination; study of
the acid-producing function of the stomach by the
aspiration-titration method and intragastric pH-metry;
according to the indications, ultrasound of the
abdominal organs was performed.
X-ray examination of the bulb and postbulbar
duodenum was performed tight filling followed by
dosed compression. Usually, the study was carried out
in the vertical position of the patient, if necessary, a
polypositional one was used, and to detect cardia
insufficiency with gastroesophageal reflux, the study
was carried out in the Trendelenburg position. All this
made it possible to significantly reduce the frequency
of diagnostic errors.
Postoperative X-ray examination after surgery was
carried out depending on the indications, but on
average for 6-7 days, because. it is during these periods
that the majority of complications are most often
manifested. After the surgical intervention, X-ray
examination studied the time of the beginning of the
emptying of the contrast from the stomach stump, the
relief of the mucous membrane, the speed and nature
of the evacuation of the contrast mass.
СОNСLUSIОN
1. The methods of decompression of the stomach
stump, the area of anastomosis and intestines that we
use are simple in execution technique, easily tolerated
by patients, there is no need for special skills and
techniques, tools to perform these techniques.
2. Decompression methods can be widely used to
prevent early postoperative complications, preventing
the development of hypertension in the early
postoperative period, and these advantages and
advantages
of
the
decompression
technique
contribute to the regression of inflammatory changes
in the "zone of interest", and conditions are created for
better healing.
3. In addition, constant decompression in the
conditions of the operated stomach and duodenum
contributes to a more rapid recovery of the motor-
evacuation function of these organs, which is the
prevention of congestion.
Volume 03 Issue 05-2023
99
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
05
P
AGES
:
96-99
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
RЕFЕRЕNСЕS
1.
Ataliev A.E., Khodzhibaev M.Kh., Arifzhanov Z.Sh.
et al. Analysis of the results of early laparotomy//
Proceedings of the conference “Actual problems
of organizing emergency medical care”, Tashkent
-
Fergana, 2011.
–
P. 148
–
150.
2.
Afendulov S.A., Zhuravlev G.Yu., Smirnov A.D. The
strategy of surgical treatment of peptic ulcer //
Khir. - 2016. - No. 5. - P. 26
–
30.
3.
Belonogov N.I., Kurinny A.V., Smolkina A.V.
Prevention of post-resection anastomoses //
Proceedings of the scientific-practical conference
"Surgery-2010", Moscow, 2010, pp. 46-47.
4.
Bulgakov G.A., Kubyshkin V.A. Modern problems of
surgical treatment of uncomplicated duodenal
ulcer / / Surgery. - 2011. - No. 5. - P. 34
–
37.
5.
Gostishchev
V.K.,
Evseev
M.A.
Acute
gastroduodenal bleeding: from strategic concepts
to therapeutic tactics.- M.: Anta-Eko. - 2015. - 352 p.
6.
Mustyats A.P., Zaporozhets V.K., Khodyrev V.N.
Restoration of the motor-evacuation function of
the stomach in the early postoperative period//
Proceedings of the scientific-practical conference
"Surgery-2010", Moscow, 2010, pp. 227
–
229.
