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Surgical management of peptic ulcer disease
1Department of Surgery, Faculty of Health Sciences, Moi University, P.O. Box 4606, Eldoret, Kenya.
Objective:
To determine the pattern of surgically managed peptic ulcer disease.
Design:
A retrospective study.
Setting:
Department of Surgery, Moi Teaching and Referral Hospital, Eldoret, Kenya.
Subjects:
Fifty three patients operated on for peptic ulcer disease.
Results:
The mean age was 47 years with a male/female ratio of 1.7:1. Duodenal ulcer associated complications were the commonest with duodenal ulcer/gastric ulcer ratio of 11.5:1. Most patients had chronic peptic ulcer symptoms with inadequate or no medical treatment. Perforations were the commonest complications (56.6%) followed by gastric outlet obstruction (34.0%). Closure with omental patch was done in 83.3% of perforations while truncal vagotomy and drainage was done in gastric outlet obstruction. Hypostatic pneumonia was the commonest post-operative complication. Seventy one point seven per cent of the patients were free of dyspeptic symptoms during the brief follow-up period.
Conclusion:
Most patients with chronic peptic ulcers had had inadequate treatment and perforation was the most common complication. Repair of perforations with omental patch, and truncal vagotomy and drainage procedure for gastric outlet obstruction, were satisfactory surgical methods offered to patients at the Moi Teaching and Referral Hospital.