PERFORATED PYLORIC AND PREPYLORIC ULCERS

In Various surgical interventions were conducted in the clinic on 63 p atients for perforation of pyloric and prepyloric ulcers. Closure of t he perforated ulcer was performed in 8 patients, excision of the ulcer and transverse pyloroplasty in 14, truncal and selective vagotomy in combination with antrumectomy in 6, and truncal vagotomy and pyloropla sty in 3 patients. According to the authors, the operation of choice i s anterior seromyotomy of the body and fundus of the stomach in combin ation with posterior truncal or posterior selective vagotomy and oblig atory excision of the ulcer for histological study, and transverse pyl oroplasty of the Aust-Holle type which was performed in 22 patients. T he indications for radical operations were expanded bearing in mind th e peculiarities of the course of peritonitis in patients with perforat ed gastric ulcers. In addition to the traditional prophylactic treatme nt of the abdominal cavity, the complex treatment of peritonitis inclu ded the use of low-frequency ultrasound during the operation and prolo nged laparoscopic prophylactic treatment with low-intensity laser beam in the postoperative period.