Primary gastric resection as the method of choice for perforated gastro-duodenal ulcers

All surgeons recognize gastric resection as the best way to treat chronic gastric and duodenal ulcers. According to a number of authors (E. L. Berezov, B. A. Petrov, A. T. Lidsky, S. S. Yudin and others), after gastric resection in 90-95%, good and satisfactory results were noted. Outcomes after gastric resection with perforated gastro-duodenal ulcers are no less favorable (S. S. Yudin, B. A. Petrov, A. T. Lidsky, N. I. Kozintsev, V. P. Voznesensky, etc.). According to L.V. Poluektov, good and satisfactory results after primary gastric resection were noted in 97.1%. In 30%, repeated surgical interventions on the stomach are performed after suturing of perforated ulcers with 16.6% of poor results and the number of postoperative complications is 2 times more than after primary resections. However, primary gastric resection is not recognized by all surgeons as the method of choice. It is limited to a number of conditional and sometimes contradictory contraindications. For example, V.I. Struchkov believes that perforated gastro-duodenal ulcers at a young age are not subject to resection. Simple suturing, according to his data, in 70%, and suturing of "silent" ulcers - in 85% leads to recovery. A. N. Bakulev and B. A. Petrov adhere to the same point of view. S. S. Yudin, on the basis of studying a large number of immediate and long-term results, came to the conclusion that primary resections are advisable at a young age, since simple suturing does not guarantee either relapses or complications. According to D. V. Usov, for 245 sutured perforated ulcers in young people, good long-term results were obtained in 18.9%, satisfactory - in 34.9%, and poor - in 46.2%.