[Characteristics of diagnosis and surgical treatment of giant gastroduodenal ulcers].

Out of 1364 patients operated on in the Central Research Institute for Gastroenterology for ulcer, 130 (9.53%) appeared to have giant gastroduodenal lesions. The latter were gastric in 59 patients (more than 3 cm in diameter), duodenal in 71 (more than 2 cm in diameter). Surgical treatment of the giant ulcers is a valid therapeutic measure in view of frequent complications, uneffective conservative treatment, common recurrences. Billroth I gastrectomy was performed in 2 patients. Billroth II gastrectomy in 110 with additional bilateral subdiaphragmatic or selective vagotomy in 8 cases, Roux' operation in 2 patients. Gastroenteroanastomosis was established in 16 cases of inflammatory infiltrate, disturbed gastric evacuation, no evidence of hemorrhage from the ulcer; in 15 cases of truncal bilateral subdiaphragmatic vagotomy. Lethality reached 3.07% (4 patients), which is a relatively low rate achieved due to appropriate preoperative preparation and early surgical intervention.