Operations on the pancreas: indications, types, prognosis. Surgery of the small intestine: methods of surgical treatment

What causes the development of an ulcer twelve duodenal ulcer? What are its symptoms, treatment and in what cases can you do without surgery?

Duodenal ulcer

The disease is characterized by a periodic course and the formation of ulcers in its mucosa in the acute stage.

A duodenal ulcer is a defect that occurs in its mucous membrane, the healing process of which, for any reason, is significantly slowed down.

Causes

Most often, this disease occurs as a result of infection of the digestive system with a bacterium Helicobacter pylori. In addition, the disease very often develops against the background of hyperacidity. In this case, concentrated acid provokes the transformation of the mucous membrane of the organ, which leads to a violation of its integrity and the development of ulcers.

Sometimes a duodenal ulcer develops due to long-term use aspirin, and nonsteroidal drugs such as ibuprofen or diclofenac.

Also of no small importance in the development of ulcers is smoking, alcohol abuse, non-compliance with the diet and regular consumption of too hot food.

Hello! I am a duodenal ulcer

Suspect the development of the ulcer process allow regularly occurring pain in the abdomen. The pains appear on an empty stomach and disappear after eating. Sometimes patients complain of the occurrence of sharp dagger, as well as aching pains. The pain may radiate to the back or disguise itself as heart attack, That is characteristic symptom the fact that the defect is located in the area of ​​the bulbous duodenum.

Hunger is another sign that a duodenal ulcer has begun. Many patients begin to experience hunger within a couple of hours after eating. Patients also complain of bloating, bouts of nausea, belching and flatulence.

Very often, pain can occur during sleep long before morning awakening. This time of onset of pain is due to the increased secretion of hydrochloric acid that occurs after dinner. Intensive production of food enzymes occurs at about two in the morning. In this regard, night pains are recommended to be considered as a response of the body to increased acid production.

If you do not pay due attention to the body at this stage, then the regular occurrence of vomiting with an admixture of blood is considered quite characteristic. Blood can also be found in feces sick, which is considered clear sign internal bleeding. When large areas are involved in the ulcerative process and there is no correct therapy, perforation of the ulcer may occur, and then the operation is the only possible option treatment.

Surgery

The operation is indicated only in cases where there is an extremely serious condition patient, the development of diffuse peritonitis, massive bleeding, as well as severe exhaustion sick. In all other cases, treatment is carried out without surgical intervention and is aimed at destroying Helicobacter pylori and restoration of mucosal integrity. Of no small importance in the treatment is the diet for duodenal ulcers.

Life after surgery

After the operation associated with resection of the duodenum, the patient is recommended complete emotional rest, since the release of adrenaline enhances the secretory ability of the organ. The patient should also avoid physical activity quit smoking and stop drinking alcohol. Any recommendations related to lifestyle changes are given with the obligatory consideration of the general condition and the presence of other diseases in the patient.

Apart from drug treatment And general recommendations the patient will definitely be advised to follow a diet that provides maximum rest for the injured organ. The patient's nutrition should be fractional, frequent, and all food mechanically processed, which will not allow the body to overstrain during its processing and provide it with maximum peace.

Without a doubt, life after the operation will be very different from the one that the patient led before. However, all the efforts of doctors and the patient himself should be aimed at normalizing and improving the quality of his life.

stomach diseases, duodenum, ulcer , duodenal ulcer,

The stomach ulcer is complex disease, often having enough serious complications. With the development of many complications further treatment, usually produced surgically. It's connected with high risk lethal outcome patient, in case of non-operational intervention.

An operation such as suturing an ulcer in the stomach cavity is a fairly common and well-developed method.

Indications for surgical treatment

Peptic ulcer of the stomach and duodenum in itself is quite dangerous. This condition is defined by doctors as a precancerous period. In addition, this disease can have many other complications.

Peptic ulcer disease is characterized by the appearance of defective formations in the walls of organs digestive tract that penetrate deep muscle tissue and are irreversible. This disrupts many processes in the work. internal organs.

There is a malfunction in the activity of the secretory gland, which produces gastric juice. An increase in the release of hydrochloric acid exacerbates inflammatory process in the walls of the stomach and the development of ulcers. There is also impaired motor function. digestive organs. There is a deterioration in intestinal motility, a malfunction of the sphincters.

Often, a duodenal ulcer or stomach ulcer is accompanied by a violation of the activity of the biliary tract, pancreas and other internal organs. when under the influence various factors, the inflammatory process progresses, peptic ulcer disease can pass into other pathologies.

Indications for surgical treatment peptic ulcer are the following complications:

The procedure is performed using an endoscope. doctor tracking clinical picture on the screen, cauterizes the wound laser beam. This process is recommended to be repeated several times until the ulcer is completely healed.

Studies show that moxibustion is more effective than drug treatment. Recovery is faster, remission of the disease lasts longer. Term re-disease reduced to a minimum.

When bleeding cannot be controlled with this method, and the patient has a large blood loss, they resort to suturing the ulcer or resection of the stomach.

Suturing ulcer formations is a gentle way surgical intervention, compared to other methods. In order to prevent such operations, it is necessary to treat diseases of the digestive organs in a timely manner, which lead to irreversible complications.

Article content:

If the patient had a perforated duodenal ulcer, the diet after surgery is an important part of the treatment. When a perforated ulcer is found in a patient, surgical intervention is indispensable. Fortunately, no more than 15% of people with chronic gastrointestinal diseases suffer from it, and a perforated ulcer appears when improper treatment duodenal ulcers.

If the doctors were able to save the life of the patient, did their job, in the future his recovery depends on him. The postoperative period is very important, when the patient should be especially careful about his health and not forget about the diet prescribed after the operation.

A little about perforated ulcer

Perforation of the duodenal ulcer appears due to the fact that the patient treated the ulcer incorrectly, turned to the doctor untimely, or refused to be treated at all. Because of this, incorrect scarring of the wound occurs, and a hole is formed in the duodenum. The contents of the intestine can enter the abdominal cavity. If the patient does not undergo surgery within 18-24 hours, he may die.

The duodenum plays important role in the body, so the perforation of its wall may have severe consequences. It is important for the patient short time restore all digestive processes. To do this, you need to follow a diet. To digestive system could recover, it is necessary to create favorable conditions for it, that is, not to overload it. But it also makes no sense to completely refuse food, since all the substances it needs must enter the body.

When preparing food for a patient with an ulcer, it is important to adhere to the following rules:

1. Products are either boiled, or use a double boiler, or baked, but without a crust. Food for the patient must either be ground, or crushed as much as possible.
2. The amount of salt in dishes is minimal, and it is better to completely eliminate it.
3. The patient should not overeat or starve for a long time You need to eat often and in small portions.
4. The patient only needs to eat warm food prepared not so long ago.
5. Some foods will have to be excluded from the diet.

Drinking diet

After surgery for duodenal ulcer 12, nothing can be eaten, even the amount of water is limited. On the second day, the patient can drink water, a little, but every 20 minutes. Drinking diet lasts from 2 to 4 days, the doctor will tell you more exact numbers.

If the patient feels well, later he is allowed to drink kissels or juices made from sweet fruits or berries. You can also make a decoction of wild rose. To do this, in the evening, before going to bed, you need to pour 1 tbsp. fresh berries clean cold water(2 cups), the next day, bring the infusion to a boil.

Then the sick can drink more satisfying drink. What is this drink? Weak fresh broth made from chicken, beef or turkey or cereal broths. Patients are also allowed to eat some fruit jelly. A person can drink up to 2.5 liters per day various liquids but without salt.

Meals for the first week

Approximately on the 5th day after the perforation of the ulcer and the operation, the patient is allowed to consume not only drinks, but also food. You can already increase the portion and eat every 3 hours. The food that the patient eats should still be warm, it can be slightly salted. The amount of fluid you drink can be reduced to 2 liters.

• thick soups cooked on a decoction of vegetables, in which crushed cereals are placed;
• liquid porridge;
• egg whites, steamed in the form of an omelet;
• berry mousse;
• meat or fish soufflé.

What can you eat a week after surgery

If there are no complications, the patient recovers quickly after the operation, after 8 days you can expand the diet: prepare puree soups on diluted meat broths, dishes from fresh meat or fish, eat cottage cheese and mashed vegetables. Rolls and pies are still banned, but you can eat crackers or baked apples.

Later, it will be possible to cook meatballs or meatballs for the patient from lean meat or steamed fish, omelettes, for a change, allow the patient to eat soft-boiled eggs. If in the first weeks after the operation, the patient with an ulcer had to give up butter, both butter and vegetable, now it can be put in dishes.

Also, the patient is allowed to drink tea with milk or sugar, you can eat honey, and, if desired, jam.

As we see, the diet after perforated ulcer duodenal ulcer is not very strict, many dishes are allowed to patients. But some products will have to be abandoned not only in the postoperative period, but also later. Only 2 or 3 years after the operation, the patient can occasionally afford one of the forbidden dishes, in small quantities.

Prohibited Products

The list of products is significant, but you can find many useful recipes. diet meals allowed to the patient.

What can not be eaten by a patient with a duodenal ulcer:

• fatty meat, smoked meats, canned food;
• under the ban for those who have an ulcer, any sausages and sausages;
• you can not eat mushrooms in any form, even boiled;
• the patient will have to forget about any soda, including mineral water and kvass;
• citrus fruits are not recommended for patients;
• berries with peel, including gooseberries, also cannot be included in the patient's menu, like grapes in any form (berries, raisin juice);
• sweet pastries, bread coarse grinding, fast food forbidden to those who suffer from ulcers;
• some vegetables also cannot be eaten, namely cucumbers, cabbage, tomatoes, onions and garlic, legumes and sorrel are not recommended;
• the patient will have to give up ice cream and chocolate, coffee;
• seeds and nuts are also not allowed for the patient, as are all kinds of chips and store-bought crackers, ketchups, mayonnaise;
• alcoholic beverages for the patient is also prohibited.

What can you eat

But, despite numerous prohibitions, dietary nutrition and with a duodenal ulcer after surgery can be varied and tasty. But it is better to cook dishes for a sick person at home, trying to put a minimum of salt and oil in them. After the operation, it is advisable to talk with a gastroenterologist, ask what the patient can eat and what not. When compiling the menu, it is very important to take into account the condition of the patient, and how the disease proceeds, whether the recovery is fast.

The list of permitted dishes may include these dishes:

• boiled chicken breast with boiled potatoes, you can sprinkle it with herbs;
• low-fat fish, which must either be baked or boiled;
• diet soups with cereals or milk, you can also have broth on turkey or chicken meat;
• steamed cutlets made from rabbit, beef or chicken;
• you can eat pumpkin, carrots, zucchini and beets;
• if the patient wanted fruit, pears and bananas are allowed;
• cereals: buckwheat, rice and oatmeal.

How long to diet after surgery

After surgery has been done to treat a perforated ulcer, a strict diet must be followed. If it is abandoned, a relapse of the disease is possible. But the patient should not starve, his nutrition should be complete, so that the body receives all the necessary nutrients, including protein. This will help the rapid recovery of the patient's gastrointestinal tract. You need to stick to the diet for at least 1 month, but 3 months is better. Habitual dishes are introduced into the patient's diet not immediately, but gradually, and some products will have to be abandoned forever.

How much exactly you need to diet, what foods are allowed in a given period, the doctor will tell you, since this largely depends on the condition of the patient. You can also talk to a nutritionist who will help you make the right menu. This is especially important for those patients who have severely weakened immunity. If constipation occurs, you should also inform the doctor about it. Perhaps he will recommend food for the patient that contains fiber or allow him to drink a decoction of oat bran.

Any question, not only regarding drug treatment, but also proper nutrition you can ask the doctor, since diet is also part of the treatment, and is no less important for the patient than taking pills.

If the patient had a major operation associated with a perforated duodenal ulcer, for quick recovery The body needs to eat right. A sparing diet will help the gastrointestinal tract recover faster, and a person will be able to return to habitual diet. If you follow the recommendations of the doctors, the recovery will be fast enough, while if the diet is violated, a relapse is possible, after which you will have to undergo an additional course of treatment.

All patients with duodenal ulcer subject to surgical treatment should be divided into 2 fundamentally different groups: patients who are operated on in a planned manner, and patients operated on for urgent indications. Patients of these groups require a different approach to preoperative preparation, the choice of surgery and further treatment. Operations carried out in a planned manner and according to urgent indications are accompanied by unequal mortality and give different long-term results. Planned surgical treatment of duodenal ulcer in most cases involves the most radical intervention, and only in some cases, for example, with decompensated duodenal stenosis in extremely debilitated patients, the surgeon deliberately performs palliative surgery in the form of gastrojejunostomy or pyloroplasty to restore the patency of the gastrointestinal tract and rid the patient of progressive exhaustion. In emergency situations, the surgeon often has to lean towards a simpler surgical intervention.

stvu. It is from these positions that we will further describe the treatment of duodenal ulcers by vagotomy.

First, we will focus on the planned use of vagotomy in the treatment of duodenal ulcers for the following indications.

Failure of conservative treatment. The issues of surgical treatment of uncomplicated duodenal ulcers that are not amenable to conservative treatment are currently attracting increased attention due to the tendency that has appeared in the literature and clinical practice to operate on such patients before the development of complications [Kuzin M. I. et al., 1982]. Even a kind of aphorism is promoted: "The operation is ahead of complications." Such a tactic in relation to uncomplicated duodenal ulcer is considered acceptable due to the widespread use of vagotomy, in particular selective proximal, and its very encouraging results. Many surgeons are trying to determine the timing of conservative treatment of uncomplicated duodenal ulcers, if unsuccessful, one can raise the question of surgery. As such terms, some authors call 1-2 months [Buyanov V. M. et al., 1986], others - 1 "/a year [Kurygin A. A., 1975].

The frequency of operations for uncomplicated duodenal ulcers varies widely among different authors: from 4.3% (Mish G.D., 1980] to 26.7-34% [Nesterenko Yu. A. et al. , 1985; Chernyavsky A. A. et al., 1986; Cherno-usov A. F. et al., 1988], and in some authors such patients account for more than 60% of all those operated on for duodenal ulcers [Buyanov V. M. et al., 1986]. Most often, patients with uncomplicated duodenal ulcers are operated on by supporters of selective proximal vagotomy and very rarely by adherents of gastric resection, which in such cases gives unsatisfactory long-term results.

How active should surgical tactics in relation to patients with uncomplicated duodenal ulcer, long-term monitoring of a large number of patients undergoing surgical treatment, including vagotomy, can decide.

We subjected to vagotomy and followed up after operation for many years 162 patients with duodenal ulcer, not amenable to conservative therapy. Among these patients there were 135 men and 27 women. stem vagotomy produced in 105 patients, selective-44 and selective proximal-13. As drainage operations, pyloroplasty according to Heineke-Mikulich was performed 141 times, according to Finney - in 8 patients. All patients underwent surgery. Their follow-up dates are shown below.

From the above data it can be seen that 140 patients (86.4%) were followed up for more than 3 years after the operation, and 72 (44%) patients for more than 10 years, which makes it possible to fairly accurately assess the long-term results of the intervention, since the majority of peptic ulcer recurrences after vagotomy comes and manifests itself during the first 2-3 years [Nechai A. I. et al., 1985].

Disassembled patients by. composition is heterogeneous, and among them 2 groups can be distinguished. Group 1 included 142 patients who did not have ulcer complications at the time of surgery, but large changes were found in the duodenum in the form of an ulcer crater with an inflammatory infiltrate and adhesions around. Some of these patients had previously suffered a perforation (21 people) or bleeding (32 people). Group 2 consisted of 20 patients who had no ulcer complications in history and at the time of surgery, and radiographic and endoscopic studies, as well as during surgery, revealed minimal changes in the duodenum in the form of a small stellate scar without an ulcer crater in the duodenum. mucous membrane and without inflammatory changes around. These patients were operated on due to complaints of persistent pain. Numerous complaints of a neurotic nature are noteworthy in these patients. The results of vagotomy in these two groups of patients were not the same (Table 19).

As can be seen from the above data, in the group of patients with minimal morphological changes in the duodenum, the results were unsatisfactory: only 6 out of 20 operated patients recovered, the remaining 14 either had a relapse of the disease (9), or they continued to suffer from dyspepsia, although they did not have an ulcer (5). At the same time, among 142 patients with significant changes in the duodenum due to ulcers, recurrence of the disease and dyspeptic disorders after vagotomy occur respectively 6 and 2 times less than in patients of the previous group.

All materials on the site are prepared by specialists in the field of surgery, anatomy and related disciplines.
All recommendations are indicative and are not applicable without consulting the attending physician.

Peptic ulcer of the stomach and duodenum is a fairly common disease. The nature of peptic ulcer disease is considered to be sufficiently studied, many methods have been developed and put into practice. medicines which have proven to be very effective.

Peptic ulcer is now successfully treated conservative methods. In recent decades, indications for surgical treatment (especially elective) have declined sharply. However, there are situations when surgery is still indispensable.

In addition to pain and unpleasant symptoms that this disease delivers to the patient, it is accompanied by complications in 15-25% (bleeding, perforation or food obstruction), which requires surgical measures.

All operations performed for stomach ulcers can be divided into:

• emergency- Basically, this is suturing a perforated ulcer and resection of the stomach in case of bleeding.
• Planned- resection of the stomach.
• open method.
• Laparoscopic.

Indications for surgery for gastric ulcer

The main operations that are performed for peptic ulcer at the present time are gastric resection and suturing of the perforated hole.

Some other types of operations (vagotomy, pyloroplasty, local excision of an ulcer, gastroenteroanastomosis without stomach resection) are very rare today, since their effectiveness is much lower than gastric resection. Vagotomy is performed mainly for duodenal ulcers.

Features of the selection of patients for surgical treatment of peptic ulcer

In emergency situations (perforation, bleeding), the question is about the life and death of the patient, and here there is usually no doubt about the choice of treatment.

When we are talking about planned resection, then the decision should be very balanced and thoughtful. If there is even the slightest opportunity to manage the patient conservatively, this opportunity should be used. The operation can get rid of the ulcer forever, but adds other problems (quite often there are manifestations designated as the syndrome of the operated stomach).

The patient should be informed as much as possible both about the consequences of the operation and about the consequences of not taking surgical measures.

Contraindications for surgery for gastric ulcer

At life threatening conditions requiring emergency measures, there is only one contraindication - the agonal state of the patient.

For planned operations on the stomach, surgery is contraindicated in:

• Acute infectious diseases.
• heavy general state sick.
• Chronic comorbidities in the stage of decompensation.
• Malignant ulcer with distant metastases.

Operations for perforation of an ulcer

A perforated stomach ulcer is emergency. If the operation is delayed, it is fraught with the development of peritonitis and the death of the patient.

Usually, when the ulcer is perforated, it is sutured and sanitized. abdominal cavity, less often - emergency resection of the stomach.

Preparation for emergency surgery is minimal. The intervention itself is performed under general anesthesia. Access - upper median laparotomy. A revision (examination) of the abdominal cavity is performed, a perforated hole is located (it is usually a few millimeters), and it is sutured with absorbable suture. Sometimes, for better reliability, a large omentum is sewn to the hole.

Further, the contents of the stomach and effusion that have got there are sucked out of the abdominal cavity, the cavity is washed with antiseptics. Drainage is being established. A probe is inserted into the stomach to aspirate the contents. The wound is sutured in layers.

For several days the patient is on parenteral nutrition. IN without fail antibiotics are prescribed a wide range actions.

At favorable course on the 3rd-4th day, the drainage is removed, the sutures are usually removed on the 7th day. Ability to work is restored in 1-2 months.

With the development of peritonitis, a second operation is sometimes required.

Suturing a perforated ulcer is not radical operation, it's only emergency measure to save lives. The ulcer may reappear. In the future, it is necessary to regularly examine for early detection exacerbations and the appointment of conservative therapy.

Resection of the stomach

The most common operation for peptic ulcer is this. It can be carried out as urgent order(with bleeding or perforation), and planned (chronic long-term non-healing, often recurrent ulcers).

It is removed from 1/3 (with ulcers located close to the exit section) to 3/4 of the stomach. If malignancy is suspected, subtotal and total resection () may be prescribed.

resection of the stomach

It is preferable to resect a part of the stomach, and not just excise the area with an ulcer, because:

1. Removing only the ulcer will not solve the problem as a whole, the peptic ulcer will recur, and you will have to do a second operation.
2. Local excision of the ulcer with subsequent suturing of the stomach wall can cause further rough cicatricial deformity with a violation of the patency of food, which will also necessitate a second operation.
3. Gastric resection surgery is universal, it is well studied and developed.

Preparing for the operation

To clarify the diagnosis, the patient must undergo:

• Gastroendoscopy with biopsy from the ulcer.
• X-ray contrast examination of the stomach to clarify the function of evacuation.
• Ultrasound or CT of the abdominal cavity to clarify the condition of neighboring organs.

If there are concomitant chronic diseases consultation of relevant specialists is necessary, compensation for vital important systems(cardiovascular, respiratory, blood sugar levels, etc.) In the presence of foci chronic infection they need sanitation (teeth, tonsils, paranasal sinuses nose).

At least 10-14 days before the operation are prescribed I:

1. Blood tests, urine tests.
2. Coagulogram.
3. Determination of the blood group.
4. Biochemical analysis.
5. Blood test for the presence of antibodies to chronic infectious diseases(HIV, hepatitis, syphilis).
6. Therapist's review.
7. Examination by a gynecologist for women.

Operation progress

The operation is performed under general endotracheal anesthesia.

The incision is made in the midline from the sternum to the navel. The surgeon mobilizes the stomach, ligates the vessels leading to the part to be removed. At the border of removal, the stomach is sutured with either an atraumatic suture or a stapler. The duodenum is stitched in the same way.

Part of the stomach is cut off and removed. Next, an anastomosis is applied (most often "side to side") between the remaining part of the stomach and the duodenum, less often - the small intestine. A drainage (tube) is left in the abdominal cavity, a probe is left in the stomach. The wound is sutured.

A few days after the operation, you can not eat and drink (intravenous infusion of solutions and liquids is being established). The drainage is usually removed on the 3rd day. The stitches are removed on the 7-8th day.

Painkillers are prescribed and antibacterial drugs. You can get up in a day.

Laparoscopic surgery for stomach ulcers

Laparoscopic surgery is increasingly replacing open surgical interventions. With the help of this technique, it is now possible to carry out literally any operation, including gastric ulcer (suturing of the perforation of the stomach wall, as well as resection of the stomach).

Laparoscopic surgery is performed using special equipment not through a large incision in the abdominal wall, but through several small punctures (for inserting a laparoscope and trocars for accessing instruments).

In this case, the stages of the operation are the same as with open access. Laparoscopy also requires general anesthesia. Stitching of the walls of the stomach and duodenum during resection is carried out either with a conventional suture (which lengthens the operation) or with staplers (like a stapler), which is more expensive. After cutting off part of the stomach, it is removed. For this, one of the punctures in abdominal wall expands to 3-4 cm.

The advantages of such operations are obvious:

• Less traumatic.
• No large incisions - no post-operative pain.
• Less risk of suppuration.
• Blood loss is several times less (coagulators are used to stop bleeding from crossed vessels).
• Cosmetic effect - no scars.
• You can get up a few hours after the operation, minimum term stay in the hospital.
• Short rehabilitation period.
• Less risk postoperative adhesions and hernia.
• Multiple magnification with laparoscope operating field allows you to perform the operation as delicately as possible, as well as to examine the condition of neighboring organs.

The main difficulties associated with laparoscopic operations:

1. Laparoscopic surgery takes longer than usual.
2. Expensive equipment and consumables are used, which increases the cost of the operation.
3. A highly qualified surgeon and sufficient experience is required.
4. Sometimes during the operation, a transition to open access is possible.
5. Not all peptic ulcer conditions can be operated on using this technique (for example, laparoscopic surgery will not be prescribed for large sizes perforation, as well as with the development of peritonitis)

Video: laparoscopic suturing of a perforated ulcer

After operation

Within 1-2 days after the operation, food and liquid intake is excluded. Usually on the second day you can drink a glass of water, on the third day - about 300 ml of liquid food (fruit drinks, broths, rosehip broth, a raw egg, lightly sweetened jelly). Gradually, the diet expands to semi-liquid (mucous cereals, soups, vegetable puree), and then to thick boiled food without seasonings with a minimum salt content (steamed meatballs, fish, cereal porridge, low-fat dairy products, steamed or baked vegetables).

Any canned food, smoked meats, seasonings, coarse food, hot dishes, alcohol, pastries, carbonated drinks are prohibited. The volume of food at one time should not exceed 150-200 ml.

A strict restrictive diet with 5-6 meals a day is recommended for 1-1.5 months.

At open operations within 1.5 - 2 months, it is recommended to limit heavy physical exertion and wear postoperative bandage. After laparoscopic operations, this period is less.

Complications after surgery

Early Complications

• Bleeding.
• Suppuration of the wound.
• Peritonitis.
• Seam failure.
• Thrombophlebitis.
• Pulmonary embolism.
• Paralytic intestinal obstruction.

Late Complications

1. Ulcer recurrence. An ulcer can occur both in the remainder of the stomach and in the area of ​​the anastomosis (more often).
2. dumping syndrome. This is a symptom complex of vegetative reactions in response to a rapid intake of undigested food into the small intestine after gastric resection. Manifested by severe weakness, palpitations, sweating, dizziness after eating.
3. Afferent loop syndrome. It is manifested by bursting pains in the right hypochondrium after eating, bloating, nausea and vomiting with bile.
4. Iron deficiency and B-12 deficiency anemia.
5. Intestinal dyspepsia syndrome (bloating, rumbling in the abdomen, frequent liquid stool or constipation).
6. Development of secondary pancreatitis.
7. Adhesive disease.
8. Postoperative hernias.

Prevention of complications

emergence early complications depends mainly on the quality of the operation and the skill of the surgeon. On the part of the patient, only the precise implementation of the recommended diet is required here, motor activity and etc.

To prevent late complications To make your life as easy as possible after the operation, you should follow the following recommendations:

• Get regular check-ups with a gastroenterologist.
• Compliance with the fractional mode diet food within 6-8 months until the body adapts to the new conditions of digestion.
• Reception enzyme preparations courses or "on demand".
• Taking supplements with iron and vitamins.
• Restriction of heavy lifting for 2 months to prevent hernia.

According to patients who underwent gastric resection, the most difficult thing after surgery is to give up their eating habits. and adjust to the new diet. But it needs to be done. Adaptation of the body to digestion in a shortened stomach lasts from 6 to 8 months, in some patients - up to a year.

Usually there is discomfort after eating, weight loss. It is very important to survive this period without any complications. After some time, the body adapts to the new state, the symptoms of the operated stomach become less pronounced, the weight is restored. The person lives normally full life without part of the stomach.

Operation cost

Operations for stomach ulcers can be performed free of charge in any department abdominal surgery. emergency operations with perforation and bleeding, any surgeon can perform.

Prices for operations in paid clinics depend on the rating of the clinic, the method of operation (open or laparoscopic), used Supplies, length of stay in the hospital.

Prices for resection of the stomach range from 40 to 200 thousand rubles. Laparoscopic resection will cost more.