[Gastric resection after the suturing of perforated ulcers]

The article deals with the authors' experience in reoperations for complications of peptic ulcer occurring after suturing of a perforation. The stomach was resected in 237 patients, after Billroth I in 71.3 and after Billroth II in 28.7% of cases. The indications for operation were as follows: recurrent perforation, stenosis, penetration, bleeding from the ulcer, as well as peptic ulcer of the gastroenteroanastomosis. Total mortality rate was 1.26%; it was higher in the Billroth II operation (3%). The authors analyse the specific features of surgical interventions after closed penetrating ulcers, which make performance of the principal moments of gastric resection and prevention of possible complications easier. Preference is given to the first method of gastric resection which was applied in 70% of cases. The peculiarities of formation of the gastroduodenal anastomosis during a adhesive process and the main contraindications for its establishment are described.