Assuntos
Traumatismos Abdominais/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Drenagem/métodos , Lesão Pulmonar/cirurgia , Traumatismo Múltiplo/cirurgia , Traumatismos Abdominais/diagnóstico , Acidentes de Trânsito , Seguimentos , Humanos , Lesão Pulmonar/diagnóstico , Masculino , Traumatismo Múltiplo/diagnóstico , Índice de Gravidade de Doença , Adulto JovemAssuntos
Úlcera Duodenal/complicações , Varizes Esofágicas e Gástricas , Hemorragia Gastrointestinal/tratamento farmacológico , Hemostáticos/uso terapêutico , Octreotida/uso terapêutico , Úlcera Péptica Hemorrágica/tratamento farmacológico , Úlcera Gástrica/complicações , Idoso , Feminino , Hemostáticos/administração & dosagem , Humanos , Masculino , Metanálise como Assunto , Pessoa de Meia-Idade , Octreotida/administração & dosagem , Úlcera Péptica Hemorrágica/etiologia , Recidiva , Fatores de TempoRESUMO
An experience with surgical treatment of 1027 patients with perforated gastroduodenal ulcers was analyzed. Radical operations were performed on 541 patients (52.7%), palliative operations on 486 patients (47.3%). Total lethality was 7.5%, among them 13.2% after the palliative procedures, 2.4% after radical ones (p < 0.01). With all well-known risk factors (age older than 60 years, coexistent diseases, preoperative shock, time since the moment of perforation more than 24 hs, diffuse peritonitis etc.) the reliably lower lethality and less amount of early complications were noted after the bilateral truncal subdiaphragmatic vagotomy with dissection of the ulcer and pyloroplasty. The minimum volume of surgical interventions must be chosen in patients with critical general condition and terminal phase of intraperitoneal infection. Palliative operations (dissection and suture of the ulcer) are justified for perforating ulcers of the antral portion and body of the stomach against the background of risk factors.
Assuntos
Úlcera Duodenal/complicações , Úlcera Péptica Perfurada/cirurgia , Úlcera Gástrica/complicações , Adulto , Idoso , Causas de Morte , Úlcera Duodenal/mortalidade , Úlcera Duodenal/cirurgia , Emergências , Feminino , Gastrectomia , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos , Úlcera Péptica Hemorrágica/mortalidade , Úlcera Péptica Hemorrágica/cirurgia , Úlcera Péptica Perfurada/mortalidade , Piloro/cirurgia , Fatores de Risco , Úlcera Gástrica/mortalidade , Úlcera Gástrica/cirurgia , Vagotomia TroncularRESUMO
Truncal subdiaphragmatic vagotomy with pyloroplasty was used in 28 patients with chronic relapsing pancreatitis, 19 of them were inclined to alcohol abuse. In 27 patients followed-up during 3 years, 18 were delivered from pain attacks resulting from chronic pancreatitis, the attacks became rarer and less intense in 4 patients, 3 patients had single attacks of pancreatic colic. In 2 patients the results of treatment were assessed as unsatisfactory due to often admission to the hospital for pain attacks. They were not found to have increased excretory and endocrine insufficiency of the pancreas in this period, but had mental disorders.
Assuntos
Dor/cirurgia , Pâncreas/inervação , Pancreatite/cirurgia , Vagotomia Troncular/métodos , Adulto , Idoso , Doença Crônica , Diafragma/inervação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Pancreatite/complicações , RecidivaRESUMO
An analysis of immediate and remote results of supraduodenal choledochoduodenostomy used in 310 patients with acute cholecystitis and diseases of extrahepatic bile ducts enabled the authors to establish exact indications and contraindications to supraduodenal choledochoduodenostomy as one of the methods of finishing choledochoduodenostomy. This method is recommended for elderly and senile patients when elimination of the obstacle for bile outflow in the terminal part of hepaticocholedochus was thought to be impossible or not reliable.
