Minimally Invasive Interventions in Surgery of Perforated Duodenal Ulcers

Abstract

Objective: To improve the results of surgical treatment of patients with perforated duodenal ulcers by a substantiation of indications for laparoscopic and traditional surgical intervention. Material and Methods: The analysis of results of treatment of 212 patients with perforated duodenal ulcer, complicated by diffuse peritonitis, who were hospitalized in the emergency surgery department of 2 - clinic of the Tashkent Medical Academy for the past 8 years. All patients were divided into three clinical groups. Results: 120 patients of first group with perforated ulcer suturing performed by laparotomy access; second A group - 55 patients operation carried out through a mini-access under video-control; second B group - 37 patients underwent laparoscopic suturing of perforated ulcer. Patients who were executed on the testimony of draining the stomach surgery and vagotomy with antrumectomy gastrectomy, in this study are not included. Complications in all groups were largely associated with traumatic laparotomy access: in the first group in 18 (16.1%) patients, of whom 11 (9.2%) were observed wound complications; and in the second A group in 2 (3.6%) patients in the second B group 1 (2.7%) patients had complications such as surgical wound seroma, early adhesive intestinal obstruction and intestinal paresis. Conclusion: Today, in the presence of the indications for suturing perforated ulcers and ulcer healing predicted the substrate, the optimal methods are minimally invasive surgery with the conduct of a comprehensive anti-ulcer therapy in the postoperative period