Analysis of surgical treatment of duodenal ulcers with multiple combined complications

The aim of the research. Analysis of results and development of surgical tactics for the treatment of DU with multiple combined complications. Materials and methods. The results of the analysis of surgical treatment of duodenal ulcers with multiple combined complications (3 and 4 combined complic...

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Autores principales:	Pavlo Ivanchev, Maxim Bilyachenko, Anton Kurbanov, Oleksii Lissov
Formato:	article
Lenguaje:	EN
Publicado:	Scientific Route OÜ 2021
Materias:	complicated duodenal ulcer perforation bleeding penetration stenosis vagotomy gastrectomy Medicine R
Acceso en línea:	https://doaj.org/article/f3dc565436624dba999b759c9046cd3c
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spelling	oai:doaj.org-article:f3dc565436624dba999b759c9046cd3c2021-11-12T09:47:19ZAnalysis of surgical treatment of duodenal ulcers with multiple combined complications2585-66262585-663410.21303/2585-6634.2021.002151https://doaj.org/article/f3dc565436624dba999b759c9046cd3c2021-10-01T00:00:00Zhttp://journal.eu-jr.eu/ttism/article/view/2151https://doaj.org/toc/2585-6626https://doaj.org/toc/2585-6634The aim of the research. Analysis of results and development of surgical tactics for the treatment of DU with multiple combined complications. Materials and methods. The results of the analysis of surgical treatment of duodenal ulcers with multiple combined complications (3 and 4 combined complications) for 3 periods are presented: 1st (1983–1995) (group A) – 77 patients, 2nd (2000–2007) years (group B) – 30 patients and 3rd (2008–2020) (group C) – 46 patients. Results. 153 patients (100 %) underwent surgery for complicated duodenal ulcer (DU), of which 130 patients (84.9 %) had a combination of three complications and 23 (15.1 %) had four complications. Bleeding complications were noted in 139 of 153 patients, accounting for 90.8 %, and ulcer perforation in 69 patients, accounting for 45.1 % of all other complications. Based on the obtained data of the analysis, there is a steady tendency to increase the proportion of organ-preserving operations (OPO) by 1.5 times (from 50.7 % to 76.2 %), reducing the number of gastrectomy (GR) by 3 times (from 14.5 % to 4.8 %) and palliative operations (PAL) 3.3 times (from 15.8 % to 4.8 %) with a relatively stable number of performed organ-saving operations (OSO): in group A – 17 (24.6 %) interventions, in group B – 4 (21.1 %), group C – 6 (14.3 %). Conclusions. The use of modern measures of endoscopic hemostasis allowed to operate on patients in the delayed period, and their share from the second period to the third increased 2.8 times. The number of patients who underwent emergency surgery with perforation of the ulcer as one of the complications decreased in the third period compared to the second by 2.6 times, due to the widespread use of PPIs in the conservative treatment of DU. According to the results of the analysis it became known that the chosen active-individualized tactics and developed algorithms for choosing the type of surgery allowed to achieve a stable level of postoperative mortality at 8.3 %.Pavlo IvanchevMaxim BilyachenkoAnton KurbanovOleksii LissovScientific Route OÜarticlecomplicated duodenal ulcerperforationbleedingpenetrationstenosisvagotomygastrectomyMedicineRENTechnology Transfer: Innovative Solutions in Medicine, Pp 10-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	complicated duodenal ulcer perforation bleeding penetration stenosis vagotomy gastrectomy Medicine R
spellingShingle	complicated duodenal ulcer perforation bleeding penetration stenosis vagotomy gastrectomy Medicine R Pavlo Ivanchev Maxim Bilyachenko Anton Kurbanov Oleksii Lissov Analysis of surgical treatment of duodenal ulcers with multiple combined complications
description	The aim of the research. Analysis of results and development of surgical tactics for the treatment of DU with multiple combined complications. Materials and methods. The results of the analysis of surgical treatment of duodenal ulcers with multiple combined complications (3 and 4 combined complications) for 3 periods are presented: 1st (1983–1995) (group A) – 77 patients, 2nd (2000–2007) years (group B) – 30 patients and 3rd (2008–2020) (group C) – 46 patients. Results. 153 patients (100 %) underwent surgery for complicated duodenal ulcer (DU), of which 130 patients (84.9 %) had a combination of three complications and 23 (15.1 %) had four complications. Bleeding complications were noted in 139 of 153 patients, accounting for 90.8 %, and ulcer perforation in 69 patients, accounting for 45.1 % of all other complications. Based on the obtained data of the analysis, there is a steady tendency to increase the proportion of organ-preserving operations (OPO) by 1.5 times (from 50.7 % to 76.2 %), reducing the number of gastrectomy (GR) by 3 times (from 14.5 % to 4.8 %) and palliative operations (PAL) 3.3 times (from 15.8 % to 4.8 %) with a relatively stable number of performed organ-saving operations (OSO): in group A – 17 (24.6 %) interventions, in group B – 4 (21.1 %), group C – 6 (14.3 %). Conclusions. The use of modern measures of endoscopic hemostasis allowed to operate on patients in the delayed period, and their share from the second period to the third increased 2.8 times. The number of patients who underwent emergency surgery with perforation of the ulcer as one of the complications decreased in the third period compared to the second by 2.6 times, due to the widespread use of PPIs in the conservative treatment of DU. According to the results of the analysis it became known that the chosen active-individualized tactics and developed algorithms for choosing the type of surgery allowed to achieve a stable level of postoperative mortality at 8.3 %.
format	article
author	Pavlo Ivanchev Maxim Bilyachenko Anton Kurbanov Oleksii Lissov
author_facet	Pavlo Ivanchev Maxim Bilyachenko Anton Kurbanov Oleksii Lissov
author_sort	Pavlo Ivanchev
title	Analysis of surgical treatment of duodenal ulcers with multiple combined complications
title_short	Analysis of surgical treatment of duodenal ulcers with multiple combined complications
title_full	Analysis of surgical treatment of duodenal ulcers with multiple combined complications
title_fullStr	Analysis of surgical treatment of duodenal ulcers with multiple combined complications
title_full_unstemmed	Analysis of surgical treatment of duodenal ulcers with multiple combined complications
title_sort	analysis of surgical treatment of duodenal ulcers with multiple combined complications
publisher	Scientific Route OÜ
publishDate	2021
url	https://doaj.org/article/f3dc565436624dba999b759c9046cd3c
work_keys_str_mv	AT pavloivanchev analysisofsurgicaltreatmentofduodenalulcerswithmultiplecombinedcomplications AT maximbilyachenko analysisofsurgicaltreatmentofduodenalulcerswithmultiplecombinedcomplications AT antonkurbanov analysisofsurgicaltreatmentofduodenalulcerswithmultiplecombinedcomplications AT oleksiilissov analysisofsurgicaltreatmentofduodenalulcerswithmultiplecombinedcomplications
_version_	1718431086334181376

Analysis of surgical treatment of duodenal ulcers with multiple combined complications

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