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[Surgery of peptic-acid disease: 1980-1994]
H Medina Franco1, L de la Garza Villaseñor
1Departamento de Cirugía, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.
Objective:
To evaluate the utility of surgery in the treatment of peptic ulcer disease.
Methods:
The clinical history of patients operated for peptic ulcer disease in a 15 year period were reviewed. The demographic data, indications for surgery, surgical procedure, morbidity, mortality and long term results, were analyzed.
Results:
349 patients were operated for peptic ulcer disease or its complications, 56% male. In 78% surgery was elective, mostly due to pyloric obstruction. In the remaining 22% perforation or bleeding ulcer were the main causes for emergency surgery. The most frequent elective procedure was vagotomy and drainage (66%); in urgent surgery, a definitive procedure was done in 35% of the perforations and in 94% of the bleeding ulcers. The 30-day mortality in urgent surgery was 14%; in elective surgery there was no mortality. A satisfactory long term result was obtained in 80% of the patients.
Conclusions:
An indication for surgical treatment of complicated peptic ulcer disease was above 50%, and 90 per cent in recent years. The frequency of urgent surgery is increasing and reached 60% of surgeries for this disease. Whenever possible, a definitive procedure is recommended.