Perforated peptic ulcer: long-term results after simple closure in the elderly

The relative incidence of peptic ulcer perforation in the elderly is rising, and the optimal surgical treatment has yet to be defined. To evaluate the long-term result after simple closure a follow-up study was initiated at a Swedish community hospital. During 1983-1992 a total of 151 patients were admitted with perforated peptic ulcer; 92 were elderly (i.e., 70 years or older), 63 of whom were operated with simple closure. Mortality at 30 days was 27% (17/63) and the total in-hospital mortality 30% (19/63). After a mean follow-up of 79 months, 14 of the 44 survivors are still alive. So far only three of the survivors have required additional hospitalization for complications of peptic ulcer disease. Because the rate of serious recurrences is low (14%, 6/44), it is concluded that simple closure is an adequate surgical treatment for peptic ulcer perforation in the elderly.