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Perforated gastric ulcers: resection compared with simple closure

P M Hewitt1, J Krige, P C Bornman

  • 1Dept. of Surgery, University of Cape Town, South Africa.

The American Surgeon
|October 1, 1993
PubMed
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Simple closure is a safe and effective treatment for most perforated gastric ulcers. However, gastrectomy may be considered for high-risk elderly patients or those with chronic or bleeding ulcers.

Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology

Background:

  • Perforated gastric ulcers are a surgical emergency.
  • Treatment options include simple closure and gastrectomy.

Purpose of the Study:

  • To compare the short-term outcomes of simple closure versus gastrectomy for perforated gastric ulcers.
  • To evaluate the impact of patient age on outcomes.

Main Methods:

  • Retrospective review of 134 patients with perforated gastric ulcers.
  • Comparison of morbidity and mortality between simple closure (94 patients) and gastrectomy (40 patients).

Main Results:

  • Similar morbidity (51% vs 45%) and mortality (10.6% vs 7.5%) between simple closure and gastrectomy.
  • Increased morbidity (67%) and mortality (24%) in patients over 65 years old.

Related Experiment Videos

  • Higher mortality in elderly patients undergoing simple closure (29% vs 11% for gastrectomy).

    • Conclusions:

    • Simple closure is safe and effective for the majority of perforated gastric ulcer patients.
    • Gastrectomy is a viable option for high-risk patients, including the elderly or those with chronic/bleeding ulcers.