Early definitive operation for bleeding peptic ulcer

Thirty-one patients operated on for bleeding peptic ulcer were reviewed. The concept was to make an early decision to operate and proceed as soon as the patient was haemodynamically stable. In addition to haemostasis, a definitive operation was performed. Seventeen general surgeons performed the operations. Twenty-four patients (77%) were operated on within the first 24 h. During the hospital stay, two deaths (6%) occurred; four patients (13%) re-bled postoperatively, all of whom had a second operation. During a mean follow-up of 45 months, 12 deaths occurred unrelated to peptic ulcer disease and one patient had recurrent bleeding. Proximal gastric vagotomy (PGV) was used in 10 of the 14 duodenal ulcers (71%) without any hospital mortality; one patient re-bled after the operation and another during the follow-up. These results support the view that early surgery achieves a low hospital mortality and a PGV achieves good results even when carried out by several general surgeons.