[The effect of various surgical management methods of stenosing duodenal ulcers on the stomach mucosa defence barrier].

The article deals with one of the pressing problems of clinical medicine-restoration of the mucosal defence barrier in surgery for stenosing duodenal ulcer (SDU). The authors studied the defence barrier of the mucosa of the upper part of gastrointestinal tract by measuring the transmural potential difference (TPD) and the level of oxygenation of the organ mucosa in the early and late periods after surgical treatment of 118 patients with SDU. The defence barrier of the gastric mucosa (GM) and the duodenal mucosa (D) was effectively restored after selective proximal vagotomy (SPV) with duodenoplasty (DP) performed in 58 (49.2%) patients. Evidence of this was an increase of the TPD values and oxygenation level of the mucosa, whereas after SDU with Jaboulay's gastroduodenoanastomosis (CDA) conducted in 60 (50.8%) patients, the desired restoration of the mucosal defence barrier did not occur and in some areas of the stomach and duodenum it was damaged. The incidence of recurrences was 8.6% after SPV with DP and 10% after SPV with CDA. Therefore, SPV with DP does not yield to SPV with CDA in efficacy, and from the standpoint of curing peptic ulcer it also promotes effective restoration of the defence barrier of the gastric and duodenal mucosa.