Variations reported in surgical practice for bleeding duodenal ulcers
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Brian C Reuben1, Leigh A Neumayer
1Division of General Surgery, Department of Surgery, University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT 84132, USA. Brian.Reuben@hsc.utah.edu
Background:
To determine the current surgical management of bleeding duodenal ulcers in our program, faculty (FAC) and residents (RES) were surveyed.
Methods:
FAC (n = 33) and RES (n = 42) were surveyed regarding their surgery of choice between oversew (OS) or acid-reducing procedures (ARPs) in 4 scenarios. FAC who had recertified in general surgery (RECERT) were compared with young FAC who had not and RES (RES/young FAC). Two-group comparisons were performed.
Results:
Seventy-three percent of FAC and 62% of RES responded. RES perform more ARPs on hemodynamic (HD), unstable, elderly patients than FAC (P = .013). On the elderly patient, RES/young FAC perform more ARPs in a HD stable (P = .07) and unstable condition (P = .18). HD unstable patients would undergo OS more frequently than stable patients (P = .016).
Conclusions:
In this survey, the choice of optimal surgical procedure for an acute bleeding ulcer varies among surgeons based on years of surgical experience and individual patient factors.
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