[Current orientations in surgery of haemorrhagic gastroduodenal ulcers]

Our study presents a number of 5219 gastroduodenal ulcers that have been operated during 30 years (1970-1999), from which 703 (13%) hemorrhagic ulcers. The incidence of ulcer bleedings pointed out the necessity to select patients in groups: with gastric (222-31.5% cases), duodenal (341-8.5%) and postbulbar (140-19.9%) bleedings. The medical treatment (H2 blockators, proton pump inhibitors), endoscopic procedures and substitute infusions that can solve almost all ulcer bleedings. In the first period: (1970-1985) 682 patients with bleedings have been admitted, immediate operations have been performed at 170 (25%) patients, late operations at 171 (25%); 341 (50%) patients have received medical treatment. In the second period (1986-1999) 1261 patients with ulcerative bleedings have been admitted, 102 (8.1%) patients have been immediately operated, late operations have been performed at 260 (21%) patients; 861 (71%) patients have received medical treatment. We performed 366 (52%) distal gastrectomies; 323 (46%) vagotomias, ulcer excisions + gastric drainages; 12 (2%) haemostatic sutures + VT. We had 12 deceased (3.5%) in the first 16 years, in the last 14 years--10 deceased (2.7%).