[Treatment of complications of pylorus preserving stomach resection]

Causes of unsatisfactory outcomes of pylorus preserving stomach resection are analyzed, method of prophylaxis and surgical correction is proposed. Pylorus preserving stomach resection was performed in 207 patients with chronic gastric ulcer. 2 groups of patients were compared: 166 patients who have undergone pylorus preserving stomach resection by Maky--Gorobashko (group 1); 41 patients operated according to an original method of suprapyloric stomach resection with preserving of distal Latarget nerves on serous-muscular flap formed from lesser curvature of the stomach (group 2). Of 122 examined patients of group 1 excellent and good long-term results according to Visick's criteria were achieved in 101 (82.79%), satisfactory--in 12 (9.84%), unsatisfactory--in 9 (7.37%). Bad stump evacuation due to a stable spasm of the denervated pylorus and hypokinesia of the stump were the main causes of unsatisfactory results. In group 2-39 of 41 patients were examined in long-term period. Excellent and good results were achieved in 38 patients, satisfactory--in 1. There were no unsatisfactory results.