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Surgical Treatment of Perforated Duodenal Ulcer with the use of a Mini-Access


Affiliations
1 Department of Hospital Surgery, State Medical University of Semey, 103 Abay Kunanbaev Street, Semey city, 071400, East-Kazakhstan Region, Kazakhstan
2 Department of Microbiology, State Medical University of Semey, 103 Abay Kunanbaev Street, Semey city, 071400, East-Kazakhstan Region, Kazakhstan
3 Department of Surgery No. 1. Asfendiyarov Kazakh National Medical University, 94 Tole-bi str., Almaty city, 050000, Kazakhstan
     

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The purpose of this study was to improve the immediate and long-term results of the surgical treatment of patients with perforated duodenal ulcer ulcer by excision of duodenal ulcer and duodenoplasty by using minimally invasive technologies. As research methods the following examinations were conducted: clinical and biochemical blood tests, abdominal radiography (for the presence of free gases in the abdominal cavity), ECG, FGDS followed by the repeated abdominal radiography, histological examination of biopsy material. On the operating table after the evacuation of gastric contents, gastric juice was taken through a probe, in which its volume (ml) and pH were determined. Intraoperative pH-metry was performed with pentagastrin stimulation (6 μg / kg). In the study of immediate and long-term results patients underwent a more thorough examination aimed at diagnosing postoperative complications and recurrence of the disease, identification of functional disorders. One considered the data of the patients’ complaints, fibrogastroduodenoscopy with biopsy, indicators of the secretory, motor-evacuation function of the stomach (X-ray examination). After discharge from the hospital the patient had to undergo a control examination after 6 months and 1 year after the surgery. In the long-term period (more than 1 year) the results were evaluated on the basis of a questionnaire based on Visic criteria inviting the patient for a follow-up examination at the clinic. To assess the well-being of the patient the questionnaire used the Visic classification in the modification of Yu. M. Pantsyrev with the division of the results into the following groups: excellent, good, satisfactory, unsatisfactory. The proposed video laparoscopic sanation and the use of excision of ulcers from small accesses with the implementation of duodenoplasty make it possible to: adequately sanitize the abdominal cavity, check the ulcer crater and establish the presence of stenosis and penetrating ulcer of the back duodenal wall, remove the inflammatory shaft around the ulcer, for better healing of the duodenal wound.

Keywords

Laporatomy, Duodenal Ulcer, Mini-Access, Duodenoplasty, Video Laparoscopy, Perforation, Pylorus.
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  • Alimov IA. Clinical and socio-economic efficiency of the use of a mini-access in the conditions of a central regional hospital: Theses. Tyumen, 2012.

  • Vetshev PS, Nesterov SN, Khanaliev BV. Parameters for assessing the trauma of laparoscopic and traditional operative technologies. Surgery. 2008; 12: 65-67.

  • Wysocki А, Budzynski P, Kulawik J et al. Changes in the localization of perforated peptic ulcer and its relation to gender and age of the patients throughout the last 45 years. World J. Surg. 2011; 35: 811-816. doi: 10.1007/s00268-010-0917-2.

  • Vachev AN, Kozlov AA, Sukhachev PA et al. Morphological rationale for the volume of excised tissue during surgery for perforated duodenal ulcer. Surgery. 2011; 2: 21-24.

  • Kozlov AA. Tactics of the surgeon in the treatment of patients with perforations of chronic pyloroduodenal ulcers: Theses. Samara, 2011.

  • Koryttsev VK. The expansion of the volume of surgical intervention for perforated duodenal ulcer. I.I. Grekov Bulletin of Surgery. 2010; 169 (3): 123.

  • Omarov NB. Minimally invasive treatment of perforated duodenal ulcers. Bulletin of the Russian State Medical University. Moscow, 2014; 2: 281-282.

  • Omarov NB, Aimagambetov MZh, Lubyansky VG et al. The use of the apparatus of the mini-assistant "League-7" in the surgical treatment of patients with perforated duodenal ulcer. Topical issues of medicine in modern conditions: materials of the 3rd International Scientific and Practical Conference. St. Petersburg. 2016; pp. 146-148.

  • Horgan S, Thompson K, Talamini M. et al. Clinical experience with a multifunctional, flexible surgery system for endolumenal, single-port, and NOTES procedures. Surg. Endosc. 2011. 25: 586-592.

  • Milosavljevic T, Kostić-Milosavljević M, Jovanović I, Krstić M. Complications of peptic ulcer disease. Dig Dis. 2011; 29(5): 491-3.

  • Zhernakova NO, Medvedev DS. Clinical and epidemiological features of peptic ulcer disease in different age groups. Scientific statements of Belgorod State University. The medicine. Pharmacy. 2010; pp. 10.

  • Montero PN, Acker CE, Heniford BT et al. Single-incision laparoscopic surgery (SILS) is associated with poorer performance and increased surgeon workload compared with standard laparoscopy. Am. Surg. 2011; 77(l): 73-77.

  • Sostres C, Lanas A. Epidemiology and demographics of upper gastrointestinal bleeding: prevalence, incidence, and mortality. Gastrointest Endosc Clin N Am. 2011 Oct; 21(4): 567-81. doi: 10.1016/j.giec.2011.07.004

  • Prudkov MI. Basics of minimally invasive surgery. Yekaterinburg. 2007; pp. 72-80.

  • Sazhin AV, Mosin SV, Kojoglyan AA et al. Results of laparoscopic drying of pyloroduodenal ulcers. Emergency and specialized assistance. III Congress of Moscow Surgeons: Abstracts. Moscow, 2009; pp. 45-46.

  • Shevela AI, Anischenko VV, Marinkin IO et al. Simultaneous operations in single access surgery. A.B. Vishnevsky Institute of Surgery Almanac. 2011; 6(1): 53-54.

  • Tomtitchong P, Siribumrungwong B., Vilaichone R.K. et al. Systematic review and meta-analysis: Helicobacter pylori eradication therapy after simple closure of perforated duodenal ulcer. Helicobacter. 2012; 17(2): 148-152. doi: 10.1111/j.1523-5378.2011.00928.x.

  • Lubyansky VG and Omarov NB. Efficiency of minimally invasive technologies in the surgery of perforated duodenal ulcer. Kuban Scientific Medical Herald. 2013; 4: 70-73.

  • Sazhin VP, Yushchenko GV, Bodrova NG. The effect of endovideosurgical operations on the incidence of purulent surgical complications surgery. Surgery. 2007; 9: 19-22.

  • Bertleff MJОE, Lange JF. Laparoscopic correction of perforated peptic ulcer: first choise? A review of literature. Surg. Endosc. 2010; 24: 1231-1239.

  • Lundell L. Acid secretion and gastric surgery. Dig Dis. 2011; 29(5): 487-490.

  • Gisbert JP, Calvet X. Review article: Helicobacter pylori-negative duodenal ulcer disease. Aliment Pharmacol Ther. 2009; 30(8): 791-815. doi: 10.1111/j.1365-2036.2009.04105.x.

  • Dapri G, Mourad HE, Himpens I et al. Transumbilical single-access laparoscopic perforated gastric ulcer repair. Surg. Innov. 2012; 19: 130133.

  • Najm WI. Peptic ulcer disease. Prim Care. 2011; 38(3): 383-394.

  • Stabile BE. Review of Health Policy and Ethics: A Critical Examination of Values from a Global Perspective. World Medical & Health Policy. 2012; 4(1): 1-2. https://doi.org/10.1515/1948-4682.1227

  • Vecchio R, Gelardi V, Persi A et al. Laparoscopic surgery in the elderly: personal experience in 141 cases. Laparoendoscopic & Advanced Surg. Techniques. 2010; 20(6): 527-531. doi: 10.1089/lap.2010.0045.

  • Helgstrand F, Rosenberg J, Bisgaard T. Trocar site hernia after laparoscopic surgery: a qualitative systematic review. Hernia. 2011; 15(2): 113-121.

  • Hsiao F, Tsai Y, Wen Y et al. Effect of helicobacter pylori eradication therapy on risk of hospitalization for a major ulcer event. Pharmacotherapy. 2011. 31(3): 239-247.

  • Podolsky ER, Curcillo PG. Single Port Access (SPA) Surgery- a 24-Month Experience. J. Gastrointest. Surg. 2010; 14(5): 759-767.

  • Song KY, Kim TH, Kim SN et al. Laparoscopic repair of perforated duodenal ulcers: The simple "one-stitch" suture with omental patch technique. Surg. Endosc. 2008; 22: 1632-1635.

  • Lui FY, Davis KA. Gastroduodenal perforation: maximal or minimal intervention? Scand J Surg. 2010; 99(2): 73-7. DOI: 10.1177/145749691009900205

  • Lee CW, Sarosi GA Jr. Emergency ulcer surgery. Surg Clin North Am. 2011; 91(5): 1001-13.


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  • Surgical Treatment of Perforated Duodenal Ulcer with the use of a Mini-Access

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Authors

Nazarbek B. Omarov
Department of Hospital Surgery, State Medical University of Semey, 103 Abay Kunanbaev Street, Semey city, 071400, East-Kazakhstan Region, Kazakhstan
Meirbek Z. Aymagambetov
Department of Hospital Surgery, State Medical University of Semey, 103 Abay Kunanbaev Street, Semey city, 071400, East-Kazakhstan Region, Kazakhstan
Farida S. Raikhimzhanova
Department of Microbiology, State Medical University of Semey, 103 Abay Kunanbaev Street, Semey city, 071400, East-Kazakhstan Region, Kazakhstan
Aidar D. Rаimkhanov
Department of Surgery No. 1. Asfendiyarov Kazakh National Medical University, 94 Tole-bi str., Almaty city, 050000, Kazakhstan

Abstract


The purpose of this study was to improve the immediate and long-term results of the surgical treatment of patients with perforated duodenal ulcer ulcer by excision of duodenal ulcer and duodenoplasty by using minimally invasive technologies. As research methods the following examinations were conducted: clinical and biochemical blood tests, abdominal radiography (for the presence of free gases in the abdominal cavity), ECG, FGDS followed by the repeated abdominal radiography, histological examination of biopsy material. On the operating table after the evacuation of gastric contents, gastric juice was taken through a probe, in which its volume (ml) and pH were determined. Intraoperative pH-metry was performed with pentagastrin stimulation (6 μg / kg). In the study of immediate and long-term results patients underwent a more thorough examination aimed at diagnosing postoperative complications and recurrence of the disease, identification of functional disorders. One considered the data of the patients’ complaints, fibrogastroduodenoscopy with biopsy, indicators of the secretory, motor-evacuation function of the stomach (X-ray examination). After discharge from the hospital the patient had to undergo a control examination after 6 months and 1 year after the surgery. In the long-term period (more than 1 year) the results were evaluated on the basis of a questionnaire based on Visic criteria inviting the patient for a follow-up examination at the clinic. To assess the well-being of the patient the questionnaire used the Visic classification in the modification of Yu. M. Pantsyrev with the division of the results into the following groups: excellent, good, satisfactory, unsatisfactory. The proposed video laparoscopic sanation and the use of excision of ulcers from small accesses with the implementation of duodenoplasty make it possible to: adequately sanitize the abdominal cavity, check the ulcer crater and establish the presence of stenosis and penetrating ulcer of the back duodenal wall, remove the inflammatory shaft around the ulcer, for better healing of the duodenal wound.

Keywords


Laporatomy, Duodenal Ulcer, Mini-Access, Duodenoplasty, Video Laparoscopy, Perforation, Pylorus.

References