Peptic ulcer bleeding surgery

Peptic ulcer bleeding surgical indications are: ① massive bleeding more. ② not large amount of bleeding, But the long-term conservative treatment fails. ③ past history of repeated bleeding. ④ ulcer long history of the past have combined symptoms of pyloric obstruction or perforation. ⑤ the age of 50 years old or more. Surgical treatment of peptic ulcer bleeding is the key to successful early diagnosis and timely surgery. In the course of medical treatment in the following situations such as emergency surgery should be considered: ① aged 45 and above, or the original hypertension, arteriosclerosis, once there bleeding and difficult to stop, so to emergency surgery. ② ulcer long history, has repeatedly massive bleeding, and the short interval of time, and not large amount of bleeding, but repeated bleeding. ③ sustained bleeding, the eight-hour period transfusion 400 ~ 800 ml, blood pressure is not stable or no improvement to the situation. ④ massive bleeding merger pyloric obstruction, perforation were. The rest of peptic ulcer bleeding and suitable for surgical treatment of patients may choose elective surgery. Surgical treatment of peptic ulcer bleeding style 1. Ulcer Bleeding May subtotal gastrectomy; on the activities of removing the bleeding ulcer. Kuang, or placed mesocaval; if ulcer smaller, together with the proximal duodenum ulcer resection, or a Bi-Bi I-II anastomosis. Vagotomy angioplasty of a pyloric ulcer recurrence rate and a higher rate of early rebleeding, it applies only to the elderly (> 70 years) of the high-risk patients. Vagus nerve stem gastric antrum resection - can be used for general good young patients. 2. Penetrating the posterior wall of duodenal ulcer bleeding Closed duodenal available Nissen law, the forthcoming anterior interrupted suture duodenal ulcer in the posterior wall of the distal edge, closed duodenal cavity, intestinal ulcers exclusion, in the pancreas, then 12 referring to conceal intestinal ulcers anterior end of suture in the front and ulcer pancreatic pseudocyst of the envelope, and then for Albert II of gastrointestinal suture. Attention should be paid to be soft and pancreatic duodenal anterior capsular thickening of cases, this law can be used closed duodenal stump. Duodenal fibrous scar of a serious anterior posterior wall with tremendous penetrating ulcers, may Roux-en-Y method. In the first after partial gastrectomy for gastrojejunostomy, anastomotic again in output from the mixing 60 cm of jejunum Department cut, with the duodenum its distal end-to-side anastomosis for stump, and the proximal jejunum stump anastomosis Roux-en-Y intestinal. 3. Ulcer Bleeding For resection of the distal stomach. As for the composite tube pyloric ulcer or ulcer, should add as pyloric angioplasty, and have together with duodenal ulcer, or gastric resection of the majority, such as ulcers of gastric acid secretion is high.