[Surgical treatment of perforated gastroduodenal ulcers]

Experience in surgically treating 820 patients aged 15 to 83 years who had perforated gastroduodenal ulcers is summarized. In 576 (70.2%) patients the perforated hole was sutured. Thirty-four (4.2%) patients underwent gastrectomy and 210 (25.6%) had vagotomy with drainage operation on the stomach. After surgery 39 (5.6%) patients died. Mortality rates after ulcer suturing, gastrectomy, and vagotomy with gastric drainage were 6.2, 2.7, and 0.9%, respectively. Recurrent ulcer occurred in 57.3% after ulcer suturing, in 2.9% after gastrectomy, and in 9% after gastric drainage vagotomy. By taking into consideration the high rate of recurrent ulcers following palliative interventions, the author proposes to expand indications for radical surgery in patients with serous and serofibrinous forms of general peritonitis in the reactive phase.