[Surgical treatment of patients with a bleeding giant ulcer of the stomach and duodenum].

The results of surgical treatment of 112 patients with a bleeding giant gastric, or duodenal ulcer, comprising 18.6% of the number of patients with acute ulcerous gastrointestinal bleeding operated on in the emergency order are presented. The use of active surgical tactics permitted to increase the specific weight of radical operations to 62.8%, reduce the incidence of early postoperative complications 1.8-fold, lethality--3.4-fold when compared with the results of the use of active-expectant tactics. An operation of choice in bleeding giant gastric ulcer is Billroth-I resection of the organ, or its suprapyloric resection; in ulcer location at the pyloroduodenal region--selective proximal vagotomy with ulcer excision, or selective vagotomy with antrectomy. To arrest bleeding in performance of minimal, or organ-preserving operation with vagotomy, it is necessary to perform ulcer excision, because after closing the bleeding ulcer, or suturing the bleeding vessel in an ulcer, 25.8% of the patients developed recurrency of the bleeding at the nearest postoperative period.