[Technical decisions in surgical treatment of peripapillary duodenal ulcer].

OBJECTIVE

To develop the surgical technology for prevention of duodenal, biliary and pancreatic hypertension after stomach resection for peripapillary duodenal ulcers.

MATERIAL AND

METHODS

The authors have an experience of 413 stomach resections for peptic ulcer disease. Major duodenal papilla was involved in destruction in 15 cases. The authors performed papillosphincterotomy, proximal duodenojejunostomy with involvement of major duodenal papilla into anastomosis or its transplantation into intestinal loop.

RESULTS

Acute postoperative pancreatitis occurred in all patients (100%). Satisfactory immediate results were observed in 14 patients (93.3%). Postoperative acute pancreatitis was asymptomatic in these cases and therapy was effective. There was only 1 case (6.7%) of severe postoperative acute pancreatitis following by death from multiple organ failure.

CONCLUSION

Immediate results confirm an effectiveness of surgical strategy for these patients.