Improving the tightness of the duodenal stump for “difficult” duodenal ulcers

Ruziboyzoda Kahramon Ruziboy - Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases No.1, Avicenna Tajik State Medical University, Tel: +(992)930807777. E-mail: dr.hero85@mail.ru Aim. To optimize the surgical tactics for “difficult” duodenal ulcers by increasing the tightness of the duodenal stump. Material and methods. The results of complex diagnostics and surgical treatment of 104 patients with “difficult” duodenal ulcers were analyzed. All patients were divided into two groups. The first - main group consisted of 53 (51.0%) patients, the second - control group - 51 (49.0%) patients. In 76 (73.1%) cases, the ulcer was localized in the duodenal bulb, in 38 (36.5%) cases in the post-bulbar duodenum. Results. After resection of the stomach with various methods in patients of the main group, with “difficult” duodenal ulcers, to increase tightness and prevent failure of the duodenal stump, improved methods of processing the duodenal stump were used, and for patients in the control group, well-known methods of handling the duodenal stump were used. Among the patients of the control group (n=51), in the postoperative period, in 7 (13.7%) cases, various complications occurred in the form of failure of the sutures of the duodenal stump (n=2), postoperative pancreatitis (n=4) and eventration (n=1). In 3 (5.9%) cases, a fatal outcome occurred. In patients of the main group (n=53) in the early postoperative period in 3 (5.6%) cases, postoperative pancreatitis occurred, which was treated conservatively. No lethal outcome was noted. Conclusion. Тhe treatment of patients with “difficult” duodenal ulcers presents significant difficulties, which requires a strictly individual approach.