Surgical treatment of patients with ulcerative gastroduodenal bleeding: clinical cases

The article presents two clinical cases of treatment of treating patients with ulcerative gastroduodenal bleeding from large chronic ulcers. In one case, the source of bleeding was a giant callous chronic gastric ulcer. The patient urgently underwent subtotal gastric resection with an inter-intestinal anastomosis according to the Roux procedure (18 hours after admission to the hospital), taking into account the high risk of recurrence of bleeding. In the second case, a patient with bleeding from a large chronic duodenal ulcer was operated on urgently (24 hours after admission to the hospital) in the following volumes: laparotomy, stitching of a duodenal ulcer, pyloroplasty according to Finney, subdiaphragmatic stem vagotomy. The purpose of the following clinical observation data is to demonstrate therapeutic tactics in relation to a group of patients with ulcerative gastroduodenal bleeding from large (more than 2.0 cm) chronic ulcers, high comorbidity and high risk of recurrence of bleeding.