Acute Perforated Duodenal Ulcer

Sawyers, John L.; Herrington, J. Lynwood; Mulherin, Joseph L.; Whitehead, William; Mody, Bharat; Marsh, John

doi:10.1001/archsurg.1975.01360110073013

Cited by 43 publications

(14 citation statements)

References 8 publications

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“…In The Netherlands, closure + HSV on perforated duodenal ulcers has become more popular since the first publications on this subject in 1973 [10], 1975 [17] and 1976 [11], In the clinics that received our questionnaire, simple closure, truncal vagotomy + pyloroplasty and clo sure + HSV are at the moment the most frequently applied.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Perforated Duodenal Ulcer in The Netherlands

Reynders¹,

Hoitsma²,

Meijer³

et al. 1986

Dig Surg

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Research has been done into (1) the results of the surgical treatment of the perforated duodenal ulcer in 1983 in 122 patients in 8 university and 12 main training hospitals, and (2) into the possible changes of the surgical policy and the incidence before and after the introduction of cimetidine in the period 1970–1982. Most important changes in policy were the introduction of suture + HSV and a decrease of simple suture and partial gastrectomy. An average of 6 perforated duodenal ulcers per year per clinic was maintained in the period before and after the introduction of cimetidine. Under 40 years of age, male patients suffered far more perforations than female patients; over 70 years, female patients suffered twice as many perforations as male patients. Of the medicines used by patients before perforation (especially older patients), 45% had potentially mucosa-damaging characteristics. Of the patients younger than 60 years, 75% was hospitalized within 12 h; of the patients older than 60 years it was only less than 50%. There was no consensus on the use of antibiotics. Mortality rate was 19% (23 patients, all in the age group 60 years and older). The main cause of death was sepsis. Up until 1983, simple closure and truncal vagotomy + pyloroplasty seemed to be the most frequent surgical treatments.

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Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Perforated Duodenal Ulcer in The Netherlands

Reynders¹,

Hoitsma²,

Meijer³

et al. 1986

Dig Surg

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“…Cassell found that only 20% of patients in the former category required subsequent surgical treatment as compared with 43.5% of those with chronic ulcers. Similarly, Sawyers et al 30 reported that in their follow‐up studies of patients treated with simple closure, 75 per cent of those patients with no previous history of peptic ulcer had remained asymptomatic. In contrast only 23 per cent of the patients with previous chronic ulcer symptoms had remained symptom‐free (Fig 1).…”

Section: Figurementioning

confidence: 94%

“…Many authorities 8, 30, 25 have quoted better mortality and morbidity statistics for their cases treated by definitive surgery than for those having simple suture of the perforation. However, some care is needed in interpreting these results.…”

Section: Figurementioning

confidence: 99%

The Management of Perforated Gastric and Duodenal Ulcers

Chalstrey

1980

Int J Clinical Practice

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“…Die Zahlen schwanken um 10% [5,8,9,18,20]. Im eigenen Krankengut lag die Letatit~it in einem frtiheren Beobachtungszeitraum bei 13%, jetzt wahrscheinlich hervorgerufen durch den h6heren Anteil ~tlterer Menschen bei 19%, Die Letalit/it der prim/iren Resektion bei Ulcusperforation liegt durchweg tiber 10% mit Ausnahme der Arbeitsgruppen, die sich speziell mit dieser Therapie bei Ulcusperforation befassen [4,9].…”

Section: Daten Zur Therapie Der Ulcusperforation Aus Retrospektiven Uunclassified

“…Liegt eine Ulcusperforation ohne oder mit nur kurzfristiger bis maximal drei Monate andauernder Anamnese vor, sind die Langzeitergebnisse besser. Sawyers fand nach der einfachen l~lbern~ihung chronischer Ulcera eine Morbidit~t von 77% gegenOber 28% bei akutem Ulcus..~Janliche Ergebnisse wurden in einer neueren Untersuchung von Heumann in Schweden gefunden [6,18].…”

Section: Daten Zur Therapie Der Ulcusperforation Aus Retrospektiven Uunclassified

13. Perforation: Welche Therapie ist gesichert beim Ulcus ventriculi und Ulcus duodeni?

Rothmund

Pitsch

1985

Langenbecks Arch Chiv

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Simple suture as standard treatment of perforated ulcer has been doubted because of high postoperative morbidity and reoperation-rate due to recurrent disease. Prospective studies showed that definitive surgery can decrease morbidity without increasing mortality. Selection is the important point. Patients with risk factors and perforation of acute ulcer should be treated by simple suture, patients without risk factors and perforation of chronic ulcer by definitive surgery (SPV + suture).

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Acute Perforated Duodenal Ulcer

Cited by 43 publications

References 8 publications

Surgical Treatment of Perforated Duodenal Ulcer in The Netherlands

Surgical Treatment of Perforated Duodenal Ulcer in The Netherlands

The Management of Perforated Gastric and Duodenal Ulcers

13. Perforation: Welche Therapie ist gesichert beim Ulcus ventriculi und Ulcus duodeni?

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