[Surgical treatment of perforated gastroduodenal ulcers in young persons]

The knowledge of surgical tactics in treatment of ulcerous disease and its complications in young persons is of great practical importance for military health service. The problem of choice of surgical method in perforated gastroduodenal ulcers remains contradictory. Many authors draw attention to merits and demerits of both palliative and radical interventions. The long-term results of identical operations obtained by different authors often vary and not infrequently are quite opposite. The review of our and foreign literature concerning the surgical treatment of perforated gastroduodenal ulcers in the young patients shows that the unequivocal decision of this problem today is not available. Discussions about expediency to perform different interventions in the young patients are generally concentrated around the notions of "acute" and "chronic" ulcer. However both these categories are poorly defined because the criteria of their evaluation vary in different authors. Obviously the choice of surgical method in the young patients with perforated gastroduodenal ulcers should be based both on multi-factor analysis of anamnestic data, the patient's general state, intraoperative picture and on retrospective and prospective analysis of conservative treatment, its possibilities and efficiency, on the patient's opinion. The availability of technical possibilities to perform the operation and presence of the adequately trained surgeons are necessary.