[Modern methods of perforative duodenal ulcer treatment].

The results of treatment of 150 patients, suffering gastroduodenal perforative ulcer, using laparoscopic method, were studied. Depending on the operations volume, they must be divided on palliative, conditionally radical and radical. The operation volume choice has depended on the patient age, the ulcer disease duration and the course character, as well as the conservative therapy efficacy. Laparoscopic interventions were performed in 138 (92%) patients and laparoscopically-associated--in 12 (8%). Complications in the early postoperative period have had occurred in 4 (2.7%) patients. Postoperative recurrence of ulcer was revealed during three years in 14 (9.3%) patients.

[Optimization of surgical treatment of patients with recurrent inguinal hernia].

The results of surgical treatment of 687 patients, ageing 22-78 yrs old and suffering inguinal hernia recurrence, are analyzed. The operative intervention choice was established in accordance with presence of the certain hernia type as well as inguinal dehiscence height and degree of atrophic changes in musculo-aponeurotic structures of inguinal channel. After the operation inflammatory complications were observed in 50 (7.3%) patients and they were eliminated, using adequate conservative measures. In 2 (0.3%) patients the operative wound suppuration have occurred. In 2 (0.36%) patients the hernia recurrence have occurred in far remote period as a consequence of the operative wound suppuration.

[Application of laparoscopic technologies in the treatment of peritonitis, caused by duodenal ulcer perforation].

Results of treatment of 105 patients suffering peritonitis, caused by duodenal ulcer perforation, using laparoscopic technologies were studied up. In terms up to 6 hours from the perforation occurrence 68 (64.8%) patients were admitted to the hospital, from 6 to 12 hours--23 (21.9%), from 12 to 24 hours--14 (13.3%). Local peritonitis was diagnosed in 12 (11.4%) patients, extended one--in 71 (67.6%), general--in 22 (21%). Serous peritoneal exudate was revealed in 65 (61.9%) observations, serofibrinous one--in 27 (25.7%), fibrinopurulent--in 13 (12.4%). The peritoneal cavity sanation, depending on the inflammation character and extension, was performed using from 1 to 91 of antiseptic solution and assistance of irrigation-aspiration system. Necessity to perform conversion have occurred in 3 (2.8%) patients in presence of intestinal paresis, necessitating the intestinal intubation performance. In 7 (6.7%) patients, admitted to hospital in terms later than 12 hours from the ulcer perforation moment, in 12-24 hours after laparoscopic operation performance the elective videolaparoscopic sanation of peritoneal cavity was done.