[The current problems of the surgical procedure in acute hemorrhages from gastroduodenal ulcers].
The article presents results of treatment of bleeding gastroduodenal ulcers in 1010 patients for 23 years. The active temporizing policy during the first 8 years resulted in 8.1% lethality while the active methods gave 8.24% lethality in six times greater number of patients. In the active policy urgent and emergency operations were performed on 43.6% of the patients with postoperative lethality 12.9%. Lethality among non-operated patients was 4.6%. Using the active surgical methods allowed lethality to be substantially decreased in the group of non-operated patients. The postoperative lethality was stabilized due to a less amount of recurrent bleedings and of "operations of despair". Recommendations are given to restrict the indications for Billroth-2 gastric resections because of a great risk of incompetent stump of the duodenum. Wider using the organ-saving operations is recommended, especially in elderly patients and against the background of haemorrhagic shock. The growing amount of patients with ulcerous gastroduodenal bleedings (which has become 2.4 times greater for the recent 15 years) makes further investigations in this direction very actual.
Losev
R Z
RZ
Chirkov
Iu V
IuV
D000208:Acute Disease; D000328:Adult; D004381:Duodenal Ulcer / Q000150:complications* / Q000401:mortality / Q000601:surgery; D004630:Emergencies; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D013276:Stomach Ulcer / Q000150:complications* / Q000401:mortality / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014628:Vagotomy
Sovremennye problemy khirurgicheskoĭ taktiki pri ostrykh krovotecheniiakh iz gastroduodenal'nykh iazv.