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Indications for surgical treatment should be placed with care, since some patients may eventually get better.

Chronic pancreatitis post-resection.

Theoretically, it is well known for regularly attacking postgastrectomy disorders of the nervous and humoral regulation of the pancreas.

Among the main causes of chronic pancreatitis include the following: first-operational trauma, leading to the development of acute pancreatitis, and then changes into a chronic, disorders resulting in the evacuation of the loop, which may as noted above, by itself have the character of clinically significant suffering, breach of the regulation of secretory gland function, coming off as a result of passage of the masses in the gut, which in turn leads to a sharp decrease in production of secretin.

Diagnosis. The clinical picture of post-resection pancreatic consists of a series of signs leading from which is a pain. Rather typical constant intensity and the intensity irradiation of pain. Often, patients suffer periodic diarrhea, lose weight.

Diagnosis of post-resection pancreatitis complicated by the limited capacity of physical and laboratory studies. On examination marked "transverse" tenderness to palpation in the projection of the pancreas, positive symptom Mayo Robson, gipnresteziya skin in the left hypochondrium. Important diagnostic value is computed tomography and ultrasound of the pancreas. Of the laboratory methods of research should be noted hypoglycemic curve with a double load, and determination of pancreatic enzymes by probing.

Treatment. Conservative treatment, diet, substitution therapy, procaine blockade of the splanchnic nerve, sedatives and painkillers. Surgical treatment is ineffective.
Recurrent peptic ulcers razvivayuisya usually in jejunum at the site of anastomosis with the stomach or near the anastomosis or in the duodenum.

The etiology and pathogenesis. Among the causes of peptic ulcer after brand viagra gastric resection should be called a lack of volume resection of the left portion of duodenum atruma, excessively long afferent loop, incomplete vagotomy, if it was done in conjunction with water-saving resection.

Occupy a special place peptic ulcer of endocrine nature (with parathyroid adenomas, Zollinger-Ellison syndrome), also in time may occur after gastric surgery, without, however, with a pathogenetic link.

Recurrence of ulcers may occur in different periods after surgery.

Diagnosis. The clinical picture of peptic ulcer is similar to the clinical picture of the former prior peptic ulcer disease. Course of the disease and the complaints of the patient more resistant, different persistence, remission periods are short. The pain is localized in the upper abdomen, often on the left, radiating to the back; relieved after eating or under the influence of antacids are short, frequently develop nocturnal pain.

Palpation in the epigastric area, usually on the left, you may find painful. Produce a study of gastric secretion, which revealed a high acidogenic function of the stomach.

X-ray examination and endoscopy are reasonably accurate methods of diagnosis of recurrent peptic ulcers.

Treatment peticheskoy ulcers without severe clinical symptoms should begin with conservative measures. If there is an expression of suffering that is resistant to antiulcer therapy, and development of complications of surgery is shown. The choice of method of operation depends on the nature of the disease and the causes that led to the development of peptic ulcers.

Postvagotomicheskie disorder. Disorders resulting from vagotomy, it is difficult to distinguish from the postoperative pathology.

Effect of vagotomy on gastric motor function in his neadakvatnom drainage can lead to phenomena gastrostaza that causes the complaints of patients as a feeling of heaviness, discomfort, fullness in the epigastrium.

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