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Perforated duodenal ulcer: which operation?

P J Gill, C F Russell

    The Ulster Medical Journal
    |October 1, 1987
    PubMed
    Summary
    This summary is machine-generated.

    Emergency surgery for perforated duodenal ulcers showed a low mortality rate. However, simple suture closure led to high rates of re-perforation and further surgery, suggesting definitive procedures are better.

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    Area of Science:

    • Gastroenterology
    • Surgical Gastroenterology
    • Clinical Surgery

    Background:

    • Perforated duodenal ulcers are a common surgical emergency.
    • Historically, simple suture closure has been the primary emergency treatment.
    • The long-term outcomes of simple closure versus definitive procedures require evaluation.

    Purpose of the Study:

    • To evaluate the long-term outcomes of emergency simple suture closure for perforated duodenal ulcers.
    • To compare the rates of re-perforation and need for subsequent surgery after simple closure.
    • To determine if a definitive ulcer procedure at the time of emergency surgery is more beneficial.

    Main Methods:

    • Retrospective analysis of 230 patients with perforated duodenal ulcers treated between 1968 and 1977.

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  • Patients underwent either simple suture closure (205) or simple closure with a definitive procedure (25).
  • Follow-up data were collected over a mean period of 10.3 years.

    • Main Results:

    • A total of 230 patients underwent emergency operations for perforated duodenal ulcers.
    • Mortality rate was 1.7% (4 deaths).
    • Over 10.3 years, 52% (107 patients) with simple closure developed further symptoms, 7 re-perforated, and 56 required elective surgery.

    Conclusions:

    • Simple suture closure for perforated duodenal ulcers is associated with a high rate of long-term complications.
    • A significant proportion of patients require further surgery after initial simple closure.
    • Performing a definitive ulcer operation during the emergency surgery for perforated chronic duodenal ulcers is recommended.