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The Role of Definitive Surgery in the Management of Perforated Duodenal Ulcer Disease

The Role of Definitive Surgery in the Management of Perforated Duodenal Ulcer Disease Abstract From 1970 to 1973, 147 patients were treated at Wayne State University Affiliated Hospitals for perforated duodenal ulcer disease. One hundred thirteen were observed for at least 18 months and findings showed that (1) mortality was dependent on the condition of the patient rather than on the choice of operation, (2) current indications (previous ulcer history, degree of peritoneal contamination, and time interval between perforation and surgery) were not reliable in choosing the initial operation or in predicting the need for subsequent surgery, and (3) morbidity was high following simple closure. Therefore, we recommend vagotomy and pyloroplasty as the procedure of choice for a perforated duodenal ulcer, unless the patient is in septic shock at admission. References 1. Graham R: The treatment of perforated duodenal ulcers . Surg Gynecol Obstet 64:235-238, 1937. 2. Nemanich GJ, Nicoloff DM: Perforated duodenal ulcer: Long-term follow-up . Surgery 67:727-734, 1970. 3. Hamilton JE, Harbrecht PJ: Growing indications for vagotomy in perforated peptic ulcer . Surg Gynecol Obstet 124:61-64, 1967. 4. McCreary JA: Management of duodenal perforations . Ann Surg 79:91-99, 1924.Crossref 5. Palumbo LT, Sharpe WS: Acute perforated peptic ulcer: Evaluation of 160 consecutive patients treated by closure . Surgery 50:863-868, 1961. 6. Maynard A, Prigot A: Gastroduodenal perforation: A report of 120 cases over a 5½-year period . Ann Surg 153:261-271, 1961.Crossref 7. Pirandozzi JS, Hinshaw DB: Vagotomy and pyloroplasty for perforated duodenal ulcer . Am J Surg 100:245-250, 1960.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

The Role of Definitive Surgery in the Management of Perforated Duodenal Ulcer Disease

Archives of Surgery , Volume 110 (8) – Aug 1, 1975

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Publisher
American Medical Association
Copyright
Copyright © 1975 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1975.01360140160031
Publisher site
See Article on Publisher Site

Abstract

Abstract From 1970 to 1973, 147 patients were treated at Wayne State University Affiliated Hospitals for perforated duodenal ulcer disease. One hundred thirteen were observed for at least 18 months and findings showed that (1) mortality was dependent on the condition of the patient rather than on the choice of operation, (2) current indications (previous ulcer history, degree of peritoneal contamination, and time interval between perforation and surgery) were not reliable in choosing the initial operation or in predicting the need for subsequent surgery, and (3) morbidity was high following simple closure. Therefore, we recommend vagotomy and pyloroplasty as the procedure of choice for a perforated duodenal ulcer, unless the patient is in septic shock at admission. References 1. Graham R: The treatment of perforated duodenal ulcers . Surg Gynecol Obstet 64:235-238, 1937. 2. Nemanich GJ, Nicoloff DM: Perforated duodenal ulcer: Long-term follow-up . Surgery 67:727-734, 1970. 3. Hamilton JE, Harbrecht PJ: Growing indications for vagotomy in perforated peptic ulcer . Surg Gynecol Obstet 124:61-64, 1967. 4. McCreary JA: Management of duodenal perforations . Ann Surg 79:91-99, 1924.Crossref 5. Palumbo LT, Sharpe WS: Acute perforated peptic ulcer: Evaluation of 160 consecutive patients treated by closure . Surgery 50:863-868, 1961. 6. Maynard A, Prigot A: Gastroduodenal perforation: A report of 120 cases over a 5½-year period . Ann Surg 153:261-271, 1961.Crossref 7. Pirandozzi JS, Hinshaw DB: Vagotomy and pyloroplasty for perforated duodenal ulcer . Am J Surg 100:245-250, 1960.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Aug 1, 1975

References