[Mortality in perforated duodenal ulcer in 35 years of experience]

The analysis of mortality rate during 35 years was the purpose of this paper. 572 person with diffuse peritonitis due to perforated duodenal ulcer were operated on in a period of years 1962-1996. Most patients were treated definitively (most frequent operation was the truncal vagotomy with pyloroplasty, then vagotomy and antrectomy, and exceptionally--gastric resection). Only in case of elderly patients, with coexisting serious diseases and advanced purulent peritonitis, or very young patients without previous digestive complains--the surgery was limited to a simple closure or only pyloroplasty (107 = 18.7%). 62 person died after the operation, that means that a general mortality rate was 10.9%. In vagotomy pyloroplasty group, the mortality rate was 2.9%, and after vagotomy with antrectomy or resection, the mortality rate reached 3.4%. In a group of patients younger than 50, 0.6% died. Above this age (people in their 50s and 60s), around 15.0%, and in the oldest group 45.2% died after the surgery. The last group (56 cases), the operation was limited to a simple closure or pyloroplasty; among these patients--30 died. A relative risk of death in men cases was higher than in women.

the age of a patient, rather than a type of surgery, influences the mortality rate in a perforated duodenal ulcer.