Medical Treatment of Gastric Ulcer: Long-Term Results in 103 Cases

Abstract

This paper describes the 254 patients with gastric ulcers admitted to the Department of Emergency Surgery of the University of Milan in the period 1978–1983. Long-term results of medical therapy are also evaluated in 103 of these patients, subdivided into two groups: 38 patients (group 1) who were followed at this department by periodic endoscopy and biopsy, and 65 patients (group 2) who were not followed systematically and were reassessed by us only at the end of the study period. In group 1 there were one case of early gastric carcinoma and one case of advanced cancer (both patients underwent radical surgery and are still alive), 10 (26%) recurrences but only one complication (hemorrhage). In group 2, 5 patients died from advanced gastric cancer, and there were 13 (20%) recurrences with 6 complications (5 hemorrhages, 1 perforation) of which 2 were fatal. Our results suggest that medical treatment should be attempted only in selected patients. Furthermore, accurate endoscopic and histologic evaluation before treatment and during regular follow-up is of paramount importance.