Показания и технологии противорецидивных операций после изолированной радикальной дуоденопластики

There are found out the mechanisms of the resistant stomach hypersecretion on the 360 patients with the relapsed duodenal ulcer after the isolated radical duodenoplasty. There are investigated the four main mechanisms of the persistent stomach hypersecretion. The main mechanism is neurode-pending vagal hyperstimulation without usage of the gastrine mechanism, which can be effectively corrected with the high selective proximal vagotomy. When the events of the gastrin-depending hyperpro-duction of the hydrochloric acid and pepsin are presented because of the hyperplasia of antral glands and with the hyperplasia of fundus glands the subtotal medial gastrectomy with the resection of the major part of the acid-producing body and innervated cardia is the most effective one. When the gastrinoma-alike variant of the hypersecretion is taken place the best way of correction is the total proximal gastrectomy and the replacement with the loop of the intestinum with the preservation of the innervated antrum. The investigation of the mechanisms, which are forming the acid and the pepsinogen aggression on the patients with the relapsed duodenal ulcer after the radical duodenoplasty allows to choose the best way of the surgical treatment and to exclude the opportunity of the relapsing of duodenal ulcer and required conservative treatment.