[Surgical treatment of postbulbar duodenal ulcers].Khirurgiia (Mosk) 1997; (5):4-9K
The results of the surgery in 121 patients with post-bulbar duodenal peptic ulcers (8.5% of all cases of duodenal ulcer) are analysed. In 72.7% the ulcer was complicated with the duodenal stenosis, in 41.3%--with the penetration, in 5.8%--choledochoduodenal fistulas. In 41.3% of the patients the course of ulcer was complicated with bleeding and in 8.3% with perforation. In 18 (14.9%) patients gastric resection was performed with total removal of the ulcer (8) or its remaining pait (10). There were no cases of mortality. In 5 cases there was postoperative pancreonecrosis. Long-term follow up results were evaluated with the use of the Visick' method. Satisfactory results were achieved in 12 patients, unsatisfactory results--in 2 patients. There were no cases of excellent and good results. Selective proximal vagotomy (SPV) was performed in 34 patients, SPV and draining operation--in 28 patients, SPV and duodenoplasty-in 41 patients. There were no mortality and serious complications. Better results were achieved with the use of SPV and duodenoplasty.