The first experience of hybrid surgical treatment in a patient with a perforative duodenal ulcer using a fully covered self-expandable nitinol stent (clinical case)

Introduction. Perforation of gastric and duodenal ulcers continues to be one of the most widespread complications of peptic ulcer disease. The main treatment method is surgical. The most common type of surgical intervention is videolaparoscopic suturing of a defect. However, in conditions of diffuse peritonitis, large infiltrative inflammation, and comorbidity of patients, especially in the presence of diabetes mellitus, the risk of suture failure is high. In order to minimize postoperative complications, new surgical techniques are being sought to avoid repeated surgical interventions.
The purpose of the study. Improving the results of treatment of patients with perforated gastroduodenal ulcers by evaluating the effectiveness of a hybrid surgical intervention.
Materials and methods of research. The article presents a clinical case of a 54-year-old patient with a diagnosis of duodenal ulcer perforation. Diffuse serous fibrinous peritonitis. The patient has numerous chronic non-communicable diseases. The Charlson Comorbidity Index (CCI) is 6.
Treatment results. The patient underwent a hybrid surgical intervention – videolaparoscopic suturing of the perforation, preventive endoscopic stenting of the perforation zone. No complications were in the postoperative period. The length of hospital stay was 9 days.
Conclusions. Hybrid minimally invasive intervention made it possible to avoid the transition to laparotomy and reduce the risk of intra- and postoperative complications in a comorbid patient. However, further studies are required for meaningful evaluations of the effectiveness of this surgical method.

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