[Surgical treatment of gastric outlet obstruction]

Today surgery for peptic ulcer disease is largely restricted to the treatment of complications. About two-thirds of operations for complicated peptic ulcer disease are due to perforations, about one-third of operations are necessary to stop peptic ulcer bleeding, despite endoscopic treatment. In rare cases, peptic ulcer penetration requires surgery. Approximately 1-2% of patients with peptic ulcer disease develop gastric outlet obstructions (GOO), and about 80% of GOO due to peptic ulcer disease are caused by duodenal ulcers. Through retrospective analysis authors make it one's aim to investigate indications, methods of treatment and outcome of treated patients, based on contemporary principles. Over a 12 year period (1993-2004) in the third surgical clinic of the Emergency Medicine Institute "Pirogov" a total of 126 patients presenting GOO are operated. There is a 4:1 male to female ratio. The middle age group is the most frequently affected (58.7%). The following operations have been done: Resection of the stomach--122 (Bilroth I--109: Billroth II--13). Gastro-entero anastomosis--2; Gastro-entero anastomosis with Vagotomia truncularis --2. The main factors to influence mortality are the presence of serious concurrent medical illnes and age above 70 years (average age of dead patients--76.3 year). Follow-up between 1 to 5 years is done according to Vizic on 40 resected patients. Authors accept resection of the stomach as a method of choice for treatment of GOO. The highly per cent of reconstruction according to Billroth 1 (86.5%) is realized by modification Haberer-Andreoiu (60 patients). Preserving the normal passage through the duodenum decreases frequency of postresection syndromes (97.5% excellent results according to Vizic).