[Surgical treatment of ulcer complicated with severe hemorrhage]

Abstract

The results of treatment of 380 patients with the globular volume deficiency of 40% and more, operated in urgency for ulcer gastroduodenal bleeding. In 124 (32.6%) of them ulcer was localized in the stomach, in 224 (64.2%)--in pyloroduodenal region, in 12 (3.2%)--the combined ulcers were revealed. Cause of the death was an acute cardiovascular insufficiency in 11.1% of patients, thromboembolia of the pulmonary artery--in 1.3%, bleeding ulcer or erosion--in 1.6%. Suture insufficiency of the duodenal stump and anastomoses occurred in 5.8%, pneumonia--in 12.6%, purulent complications--in 6.3%. The conduction of proposed surgical tactics permitted to lower the mortality after operations for persistent bleeding down to 12.5%, the prevalence of recurrent bleeding occurrence--to 12.5%. The prevalence of operations accomplishment in the patients with high risk of bleeding recurrence have increased up to 78.7%, radical intervention--to 70.7%. The authors make a conclusion about perspectivity of the proposed elaborated an active-rational therapeutical tactics in the patients with severe gastroduodenal bleeding.