Surgical treatment for pyloric stenotic ulcers

DOI: https://doi.org/10.29296/25877305-2020-01-04
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Issue: 
1
Year: 
2020

R. Sokolov; E. Stolyarchuk, Candidate of Medical Sciences; Professor О. Antonov, MDedical Doctor I.M. Sechenov First Moscow State Medical University (Sechenov University)

A literary overview of the available scientific information on the modern state of surgical treatment of stenotic ulcers of the output part of the stomach is presented. The issues of disease prevalence, morphological data, main types of surgical interventions applied at the moment, including in the historical aspect, are reflected. Modern views on the issues of etiology and pathogenesis of prepiloric and pyloric ulcers, classification H.D. Johnson et Muller, therefore, shows the inefficiency of conservative therapy, frequent exacerbation of ulcerative disease and the mechanism of formation of pyloroduodenal stenosis. The features of pre-operative preparation of patients, enteral nutrition at the pre-operative stage, indications for operative treatment are analyzed. Methods of endoscopic treatment of pyloroduodenal stenosis, organ-preserving and resection methods of surgical treatment, advantages and disadvantages of each of these surgical interventions, personalized approach in selection of one or another method of operation depending on localisation of ulcerative defect, its size, degree of pyloroduodenal stenosis, initial condition of patient are considered. The authors pay special attention to the section of work on trends in postoperative complications and ways to prevent and overcome them. The main place in this matter is the rational choice of the method of operation.

Keywords: 
gastroenterology
peptic ulcer
gastrectomy
gastroduodenal stenosis
pylorus
benign ulcerative stenosis
vagotomy



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