[The diagnostic and surgical treatment characteristics in gastric ulcer]

The work analyses a number of 283 patients suffering from gastric ulcer, which were hospitalised and operated between 1981-1991. In 64% of cases the surgical treatment decision was an emergency one for major complications of this disease such as: the upper digestive hemorrhage (27%), penetration (22%), perforation (11%), digestive stenosis (4%). In 36% of cases the decision of operation was taken for different reasons: unsatisfactory evolution under the conservatory treatment, the existence of an irreparable anatomic lesion, the recurrent ulcer or the difficulty of differential diagnosis between gastric ulcer and gastric carcinoma. It is important to indicate that the two of the major investigations: the barium transit and the fiber gastroscopy failed in giving a correct relation in 5 to 10% between gastric ulcer and gastric carcinoma. In 87% of patients it was performed the gastric resection type Péan. The lifting of the lesion in 7% of our observations needed the gastric resection on type Pochet. In the gastric ulcers Johnson II type, when the duodenal lesion couldn't be lifted we added to the Hoffmeister-Finsterer gastric resection type with truncal vagotomy. In 9% of patients with perforated or hemorrhagic gastric ulcer, the vital rise was a major one, so we performed only suture the lesion. We registered 3 deaths (1.06%).