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Vol. 15, Art. 60 (pp. 755-769)    |    2014       

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Surgical treatment and rehabilitation of patients with perforatrd duodenal ulcer

Romashchenko P.N., Maystrenko N.A., Sidorchuk P.A.
Military-medical Academy, St.-Petersburg

Brief summary

The results of examination and treatment of 152 patients with perforated duodenal ulcer in order to support a systematic approach to their surgical treatment with the modern achievements of laboratory and instrumental diagnostics, as well as opportunities for minimally invasive surgery. The results of clinical studies show that for the correct preoperative diagnosis and the choice of a rational treatment option to patients with perforated duodenal ulcers need a focused survey, including assessment of somatic condition and operating-anesthetic risk patients, pyloroduodenal zone changes and the severity of peritonitis, predicting mortality. The diagnostic algorithm can diagnose perforated duodenal ulcer before operation and to choose an adequate amount of surgery. Found that the integral evaluation of test results and surgery, determination of antibody titer to ulcerogenic strains of Helicobacter pylori, the study of the psycho-physiological profile of the patient can justify a comprehensive program of medical therapy in the postoperative period, providing remission of peptic ulcer.


Key words

perforated duodenal ulcer, peritonitis, Helicobacter pylori, truncal vagotomy, laparoscopic suture of ulcer, psycho-physiological profile.

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