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Abstract:
More than 2,000 patients with peptic duodenal ulcer (PDU) and approximately 500 patients with peptic gastric ulcer (PGU) have been operated on in the clinic since 1968. Selective proximal vagotomy (SPV) with or without a draining operation was carried out for duodenal ulcer 1,453 times; trunk vagotomy (TV) with pyloroplasty 208 times, and vagotomy in combination with economical resection of the stomach 380 times. PGU was treated by Billroth I operation in 172 patients, by Billroth II operation in 61, by TV with economical gastric resection in 90, by SPV in 27, and by TV with pyloroplasty in 218 patients. Most patients underwent complex examination in the immediate and late-term postoperative periods, on the grounds of which the advantages and shortcomings of the various operations could be determined and the optimal method of treatment chosen. SPV proved to be the method of choice in surgery for PDU, and SPV with a draining operation in the existence of a stenosis. It produces the best functional results and the incidence of a recurrent ulcer is no higher than 8.6%. TV with excision of the ulcer and pyloroplasty was the best operation in PGU. Repeated biopsy in gastroscopy and histological study of the excised ulcer during the operation is an obligatory condition for performing this operation. Only such tactics excludes malignant degeneration. With the performance of organ preserving operations in PDU and PGU the late-term results are significantly improved, the incidence of postoperative complications and invalidism is reduced, and the patients' mode of life is improved.