[Postbulbar duodenal ulcer].Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir. 1975 May-Jun; 24(3):161-7.RC
In a total of 1430 patients with gastro-duodenal ulcerative disease that have been operated the authors recorded 102 cases of duodenal ulcer in the posterior area of the bulb (7%), of which 63 also had various types of complications such as: penetration (36), stenosis (14), perforation (7), hemorrhage (4), hemorrhage and perforation (2). Six differentiated surgical techniques were employed: Reichel-Polya resection and extirpation of the lesion (30), Reichel-Polya resection with extirpation of the lesion, ligature of the duodenal stump without plugging and with epiploonoplasty (34), Reichel-Polya resection with exclusion of the ulcer (35), excision-suture with gastro-entero-anastomosis (1), excesion-suture with canula draining (1), transfixiant ligatures for hemastosis (1). A total of 23 postoperative complications were recorded with 6 deaths. By making an early diagnosis and by carrying out surgery in post-bulbar ulcers with intricated attacks, resisting medical treatment, in the pre-complication stage, these conditions being possible to achieve by a narrow cooperation with internists and by an individualization of the technique, the risks and the difficulties will be reduced with regard to closure and the morbidity, as well as the lethality following surgery will be reduced.