ORGANPRESERVING SURGERY METHODS DURING CICATRICIAL AND ULCERATIVE DUODENAL-STENOSIS ACCOMPANIED BY THE ULCER PENETRATION
Aim. To improve the results of surgery ofpatients with combined cicatricial and ulcerative duodenal-stenosis with the ulcer penetration. Materials and methods. The results of the examination and surgical treatment of 182 patients with cicatricial and ulcerative duodenal-stenosis with the ulcer penetration were analyzed. Patients were divided into three groups: the first group of 90 patients included patients that received selective proximal vagotomy in combination with duodenoplasty; the second group of 60 patients included patients that received selective proximal vagotomy in combination with drainage surgeries like cross-gastroduodenal-anastomosis (52), gastroduodenal-anastomosis according to Jaboulay (2), pyloroplasty according to Finney (6); the third group included 32 patients that received duodenoplasty or drainage operations without selective proximal vagotomy. Results and discussion. It was found, that ulcer penetration is an immanent feature of cicatricial and ulcerative duodenal-stenosis that manifests in three morphological forms: ulcerative-infiltrative, cicatricial-ulcerative, cicatricial. Selective proximal vagotomy was conducted considering the indicators of secretory and motor evacuatory functions of the stomach, duodenoplasty variants, and drainage operations. Conclusion. The choice of the duodenoplasty and drainage operation depends on topographical-anatomical features of the duodenal-stenosis and morphological form of the ulcer penetration.