[Experience of surgical treatment for stomach ulcer]

The authors have analysed the results of surgical treatment of 290 patients who underwent resection of the stomach with preservation of the pylorus for ulcer disease of the stomach with its complications, as well as polyps and benign tumors of the stomach. In 57 patients combined chronic duodenal obstruction (CDO) was revealed. In 39 of them, with CDO being compensated; simultaneously the ligament of Treitz was cut and pullthrough of duodenal junction was carried out by Strong procedure, and in 18 patients with subcompensated CDO transversal antiperistaltic duodenostomy by Ya.D. Vitebsky was carried out. 12 patients with paraesophageal hiatal hernia and with gastro-esophageal reflux disease with incompetence of the cardia, simultaneously anterior crurornaphy and fundoplication by Nissen was performed. Together with conventional methods for the diagnosis of combined CDO, the disease of the liver and the bile ducts, the pancreas, hydroultrasonographic examination of the duodenum on the background of medicamentous relaxation and contrasting of the duodenum with Barium suspension is used. Long-term results from 1 to 14 years have shown efficacy of this method in 97% of patients. The absence of the duodeno-gastral reflux and relapses of gastric ulcer is due to preservation of the pyloric sphincter muscle, the effective diagnostic procedures and adequate correction of CDO.