[Current methods of surgical treatment of perforated pyloroduodenal ulcers]

Because of the unsatisfactory long-term results, closure of a perforative duodenal ulcer should be performed in exceptional cases, for strict indications. At the modern stage of the development of surgery, vagotomy with organ-preserving operation is the most substantiated method for treating a perforative pyloroduodenal ulcer. In choice of a method of vagotomy, it is expedient to form the clinical groups. Use of vagotomy at the toxic stage of peritonitis (up to 18 h from the moment of perforation) do not lead to deterioration of the immediate results of the operation and is substantiated pathogenetically. Total postoperative lethality was 4.6%. The main cause of death together with delayed performance of the operation was a pronounced character of concomitant diseases. After vagotomy with the organ-preserving operation, there were no lethal outcomes.