Past, present and future of surgical treatment of peptic ulcer (50-year experience of the institute)

Abstract

The article presents the literature data and the results of the author’s own research on the development of peptic ulcer surgery in the historical aspect. It is shown that the evolution of the knowledge about the etiopathogenesis of peptic ulcer influenced the development of methods for surgical interventions. The main periods of development of peptic ulcer surgery are identified: the first period (1842–1881) — the time of the formation of gastric surgery; the second period (1880–90s) — the time of gastric surgery becoming an independent clinical discipline; the third period (the end of the 19th century — 1920s) — the time of peptic ulcer surgery development, when gastroenterostomy was the method of choice in surgical treatment; the fourth period (1930–60s) — the time when the pathogenetic principles of peptic ulcer surgery appeared; gastric resection served as a method of choice; the fifth (the final) period (1970–90s — present time) — the summing up of the 150-year history of ulcer surgery, when doctors tend to conservative treatment of this complex pathology, and surgical intervention in peptic ulcer is directed only to сorrection of disease complications, without destroying the digestive system. It is shown that the historical experience, the thorny path of hopes and disappointments that doctors have taken when searching an optimal approaches to the surgical treatment of peptic ulcer, will help surgeons, therapists, morphologists and physiologists in the future.

Keywords

• peptic ulcer disease
• etiopathogenesis
• history of surgical treatment
• gastroenterostomy
• resection of the stomach
• vagotomy
• duodenoplasty