POSSIBILITIES OF PREDICTING RISK FACTORS OF UNSATISFACTORY RESULTS OF SURGICAL TREATMENT OF DUODENAL ULCER

Gorpinich Alexander Borisovich

The choice of the method of surgical intervention has a significant impact on the results of surgical treatment of duodenal ulcer. It can be assumed that the degree of reliability of the decision made, when choosing an individual type of surgery, will depend on the completeness of the consideration of the factors. The aim of the study was to study the possibility of predicting risk factors of unsatisfactory results of surgical treatment of duodenal ulcer. The prognostic value of various clinical manifestations of duodenal ulcer and intraoperative anatomical changes in 99 patients with duodenal ulcer was studied. Based on the prognostic value of each factor, the second stage of this study was the construction of decision rules for determining the individual choice of the type of surgery. In this case, the problem was solved separately for each type of surgery: gastric resection, trunk vagotomy with gastroduodenostomy according to Zhabula, selective proximal vagotomy. The principles of mathematical justification of possible risk factors for unsatisfactory results of various surgical interventions for duodenal ulcer presented in the article and the decision rules applied, as well as the previously developed differentiated clinical indications made it possible to avoid the failure of the duodenal stump (within three years) and reduce postoperative mortality from 4.5% to 1.5%.

Keywords:prognosis, surgical treatment, duodenal ulcer.