[Method of selective proximal vagotomy].

A method of selective proximal vagotomy has been developed experimentally. It provides additional parasympathetic denervation of an acid-producing zone of the stomach by means of circular transsection of gastric and esophageal muscular membranes above and below cardial sphincter with forming of are flux esophageal-gastric valve. Clinical use of this method in 75 patients confirmed experimental data about a good function of the created valve and adequate decrease of acid production.

[Surgical treatment of gastric and duodenal ulcer disease with chronic duodenal obstruction].

One hundred and twenty-nine surgeries were performed from 1990 to 2001 for gastric (50) or duodenal (79) ulcers with chronic duodenal obstruction. Resection of 1/2 of the stomach by Bilrot-I was performed in 118 patients, pylorus-saving resection with creation of areflux valve in duodenal bulb--in 5, selective proximal vagotomy with duodenoplasty--in 6 patients. In early postoperative period complications were seen in 10 (10.

[Choice of surgical strategy in gastroduodenal ulcer hemorrhage].

An analysis of 567 patients aged from 15 to 89 years with gastroduodenal bleedings was made. Ulcer disease of the stomach was diagnosed in 173 (30.5%) patients, ulcer disease of the duodenum--in 354 (62.

[Diagnosis and surgical treatment of postbulbar ulcers of the duodenum].

The method of surgical treatment of postbulbar ulcers of the duodenum based on the data of their localization, complications, functional state of the stomach and duodenum, technical skills of the surgeon includes radical ablation of the ulcer, reestablishment of the gastroduodenal continuity with the formation of the functionally active anastomosis or selective proximal vagotomy. The method allows to considerably lessen the amount of complications at the early postoperative period and to obtain good functional results at late terms of observations.

[Gastric, duodenal ulcer, Helicobacter pylori and secretory immunoglobulin A before and after the surgery].

The analysis of Helicobacter pylori (HP) and secretory IgA (SIgA) effects on the course and recurrence of gastroduodenal ulcer provides grounds to suggest that a pathogenic role of HP in secretory hypofunction of the gastric stump, unchanged mucosa and normal SIgA production is not leading. Elimination of the pathological process may bring functional restoration of the stump mucosa which adapts to HP invasion. Therefore, expansion of indications to eradication therapy in late postoperative period needs further study.