[Relaparotomy in middle-aged and elderly patients with peritonitis following a primary operation for digestive...

The study covers 39,233 patients presenting biliodigestive pathology of which 12,230 in advanced and senile age, admitted to the emergency surgery section of the EMI "NI Pirogov" over a 12-year period (1985 through 1996). Of the total number, 6555 or 53.71 per cent are subjected to operation, with postoperative deaths amounting to 477 (7.27 per cent). In 320 cases (4.88 per cent) 218 men and 102 women, relaparotomy is done for postoperative peritonitis with 55 per cent lethality. Postoperative peritonitis is usually observed after operative treatment of ulcers. Operations for bleeding ulcers are performed in 175 patients of which 32 (18.28 per cent) are relaparotomized. Those operated for postoperative peritonitis are 65 per cent with 21 fatal outcomes; the commonest cause of death is insufficiency of the anastomosis or duodenal stump, followed by subhepatic and interfold abscesses.