[Surgical treatment of post bulbar stenotic ulcers].

Treatment results of 214 patients with post bulbar duodenal stenosis were analyzed. Penetrative ulcer was diagnosed in 85.9%. Surgical treatment, and notably, selective proximal vagotomy with duodenoplasty and Roux-en-Y gastric resection are considered to be methods of choice. Selective proximal vagotomy with duodenoplasty provides the best long-term results and quality of life restoration.

[Quality of life before and after surgical treatment of duodenal ulcer].

The quality of life was studied in dependence of ulcer disease severity and type of surgery. Found out that it was in close correlation with the severity and duration of the disease and the presence of complications. Patients with sub- and decompensated ulcer stenosis showed the worst quality of life. Long-term results' study demonstrated that only organ-preserving operations, rather then gastric resection, allow adequate quality of life for the operated patients.

[The reflux-esophagitis in patients with duodenal ulcer, complicated by pyloroduodenal stenosis].

The function of esophago-gastric junction is studied in 147 patients with ulcer pyloroduodenal stenosis before and after the selective proximal vagotomy (SPV) procedure. The frequency of reflux-esophagitis was 71.9%. It is determined that reflux develops due to gastric evacuatory disorders, reduction of lower esophageal sphincter tone and contraction of abdominal part of esophagus. Reflux-esophagitis develops as the consequence of aggressive gastric juices action on the esophageal mucosa. Authors reconstruct the esophageal sphincter mechanism by performing the modified fundoplication and fundoesophagocruropexy.

[Selective proximal vagotomy in combination of transverse gastroduodenoanastomosis for the treatment of ulcer pyloroduodenal stenosis].

Results of proximal vagotomy in combination of transverse gastroduodenoanastomosis (GDA) at 36 patients with sub- and decompensated ulcer pyloroduodenal stenosis are analyzed. The principles of surgical method choice depending on stenosis localization and motor-evacuatory function of stomach are discussed. Obtained results are compared with ones after selective proximal vagotomy with longitudinal GDA by Jaboule and pyloroplasty by Finney. Clinical, radiological, endoscopic and morphological data demonstrate the advantages of transverse GDA compared with longitudinal GDA and pyloroplasty.

[Selective proximal vagotomy with duodenoplasty for the treatment of ulcerous duodenal stenosis].

Short- and long-term results of isolated selective proximal vagotomy (SPV) performed at non-complicated duodenal ulcer and SPV with duodenoplastic and drainage surgeries at ulcerous pyloroduodenal stenosis were analyzed. Principles of choice of duodenoplastic and drainage surgeries are discussed. Six variants of duodenoplasty is used depending on anatomic characteristics and localization of stenosis. Advantage of duodenoplasty over drainage surgeries is demonstrated. It is concluded that SPV with duodenoplasty should be regarded as surgical method of choice at the treatment of ulcerous duodenal stenosis because of low rate of stomach and duodenum functional disorders at long-term period after surgery.

[Anti-Helicobacter therapy for duodenal peptic ulcer complicated by pyloroduodenal stenosis]. / Antikhelikobakternaia terapiia pri iazvennoi bolezni dvenadtsatiperstnoi kishki, oslozhnennoi piloroduodenal'nym stenozom.

The rate of persistence of and susceptibility of Helicobacter pylori (HP) to antibacterial drugs (ABDs) and the results of eradication therapy were studied in patients with duodenal peptic ulcer complicated by pyloroduodenal stenosis (PDS). The patients with PDS exhibited a high (97.1%) rate of anthral mucosal infection with HP showing a high resistance to ABDs. The efficiency of eradication therapy performed with the susceptibility of HP to ABDs kept in mind was 92.5%. The use of eradication therapy in the complex preoperative preparation of patients with ulcerative PDS increases the latter.

[Quamatel application in three-drug eradication therapy of duodenal ulcer and gastroduodenal ulcerations associated with helicobacter pylori infection]. / Opyt primeneniia kvamatela v troinoi éradikatsionnoi terapii iazvennoi bolezni dvenadtsatiperstnoi kishki i gastroduodenal'nykh iz''iazvlenii, assotsiirovannykh s infektsiei helicobacter pylori.

Combination of famotidine, amoxicilline and metronidasole was applied in the treatment of 71 patients with erosive-ulcerative affection of the upper gastrointestinal tract. The combination more rapidly relieved pain (within 5-6 days), dyspepsia (for 7-8 days), enabled healing of the ulcer defect for 2-3 weeks, raised gastric pH to 5.7-5.8 and eradicated Helicobacter pylori in 87.3% of the cases.

[A comparative evaluation of the results of traditional and laser stomach resection]. / Sravnitel'naia otsenka rezul'tatov traditsionnoi i lazernoi rezektsii zheludka.

Comparative evaluation of immediate and long-term results of gastric resection was made in 89 patients operated upon by a traditional method and in 69 patients after laser operations. It was found that laser scalpel used in gastric resection gives reliable hemostasis, reduces the intraoperative blood loss and the time of creation of gastroenteric anastomosis. At the same time 2 times greater amount of inflammatory complications of the anastomosis was noted. The cause of the development of anastomosis after laser resection of the stomach is discussed.

[The prevention and treatment of postoperative intestinal paralysis in peptic ulcer surgery]. / O profilaktike i lechenii posleoperatsionnogo pareza kishechnika v khirurgii iazvennoi bolezni.

Under analysis were results of using intraintestinal electrostimulation with autonomous electrostimulators of gastrointestinal tract and graded enteral probe nutrition under control of intraintestinal pressure in 68 patients after operation on the stomach and duodenum. The method gives more rapid recovery of the intestine mobility, is economically profitable, makes the risk of insufficiency of the duodenal stump after gastric resection considerably less. The method is recommended for clinical practice.

[Value of intraoperative pH-metry for predicting and preventing recurrences of duodenal ulcers after vagotomy]. / Znachenie intraoperatsionnoi pH-metrii v prognozirovanii i profilaktike retsidiva iazvy dvenadtsatiperstnoi kishki posle vagotomii.

The authors studied the results of intragastric pH measurement before, during, and after vagotomy in 75 patients with duodenal ulcer. It was established that intraoperative pH measurement, carried out by an improved procedure, provided for objective control over complete and adequate vagotomy, made it possible to predict the risk of ulcer recurrence in the postoperative period and, in accordance with that, to choose the methods for its prevention.

[Value of reinfusion of UV-irradiated autologous blood for reducing postoperative complications in peptic ulcer surgery]. / Znachenie reinfuzii obluchennoi ul'trafioletovymi luchami sobstvennoi krovi dlia snizheniia posleoperatsionnykh oslozhnenii v khirurgii iazvennoi bolezni.

The authors have studied results of 228 reinfusions of UV irradiated blood in 75 patients with ulcer disease. It was found that the procedure had a favourable effect on the patient's state, immunostimulating action resulted in a smooth postoperative period and a real reduction of the amount of postoperative complications.

[State of the valvular function of the cardia in patients with duodenal ulcer before and after vagotomy and methods of its correction]. / Sostoianie klapannoi funktsii kardii u bol'nykh iazvennoi bolezn'iu dvenadtsatiperstnoi kishki do i posle vagotomii i sposoby ee korrektsii.

The authors studied the valvular function of the cardia in 714 patients who were kept under regular medical observation and in 138 patients who had been operated on for duodenal ulcer. Changes were found in the cardia of 9.4% of patients who underwent regular medical examination and in 17% of these subjected to operation. The valvular function of the cardia was impaired after vagotomy in all cases. Fundoesophagocrurorhaphy is the best method for correction of cardiac dysfunction.

[Value of the analysis of sialic acids in patients with peptic ulcer in determining the time of preoperative management and prognosis of the course of the postoperative period]. / Znachenie sialovykh kislot u bol'nykh iazvennoi bolezn'iu v opredelenii srokov predoperatsionnoi podgotovki i prognozirovaniia techeniia posleoperatsionnogo perioda.

Results of investigations of sialic acids in blood serum of 115 patients and in gastric mucosa of 85 patients have been analyzed. It was established that sialic acids reflect the activity of the inflammatory process. Examination of the sialic acid level in the process of preoperative management and postoperative treatment allows to make timely prognosis of the risk of inflammatory complications, anastomositis in particular, and begin preventive measures and therapy of the inflammatory focus.

[Use of lasers in gastroenterology]. / Primenenie lazerov v gastroenterologii.

Under analysis were results of the surgical treatment of 120 patients with different gastroenterological diseases. It was shown that laser scalpel can be successfully used not only at key steps of the operation, but also for the dissection of other tissues but the skin and fatty tissue. Using laser scalpels gives better functional results of the abdominal surgery.

[Endoscopy of the biliary tracts and its importance in the choice of method of accomplishing an operation]. / Endoskopiia zhelchnykh putei i ee znachenie v vybore metoda zaversheniia operatsii.

The authors evaluated the diagnostic significance of endoscopy of biliary tracts. The use of cholangioscopy allowed to better diagnose cholangiolithiasis which was found in 34 patients and to avoid leaving stones in the ducts, to diagnoze different forms of cholangitis (65 patients) and to find out the type and degree of constriction of biliary ducts.