The modern approach to choice of tactics of surgical treatment of the perforated duodenal ulcer
The research is devoted to choice of tactics of surgical treatment of perforated duodenal ulcer. It is proved that the use of Proton Pump Inhibitor acid reducing therapy with Helicobacter pylori eradication after surgical incision of the perforated pyloroduodenal ulcer with pyloroduodenoplasty instead of surgical vagotomy allow to reduce pyloroduodenal stenosis and ulcer recurrence rates with minimal level of postoperative complications and high level of the life quality as compared to the control groups. As a result of analysis of omeprazole pharmacokinetics after its intravenous introduction - 21,7% patients with quick omeprazole metabolism were revealed. Correlation dependence between insufficient alkalization potential of antral stomach department and patients with quick omeprazole metabolism were revealed during the intragastric pH-metry. That can be the individual index of omeprazole dose correction and serve as a criterion for clinical efficacy.