Surgery of acute peptic ulcer haemorrhage.
During the years 1973-1985, 145 patients with acute peptic ulcer haemorrhage were treated surgically at the Department of Surgery, Turku University Central Hospital. The bleeding site was gastric ulcer in 76 patients; 58 of these were treated by gastric resection and 17 by ulcer excision combined with vagotomy and pyloroplasty. Forty-two out of 69 patients with bleeding duodenal ulcer were treated with partial gastrectomy, the remaining with transfixion and vagotomy and pyloroplasty. The rebleeding rate was 2% and reoperation rate 9% among the patients who had a resection. In contrast 19% of the transfixed and 12% of ulcer excision cases rebled. The primary overall mortality was 12%; 44% of the patients with recurrent bleeding died. Because rebleeding was the most important cause of mortality, partial gastrectomy in bleeding gastric as well as duodenal ulcer may be preferable.
Kuttila
K
K
Department of Surgery, University of Turku, Finland.
Havia
T
T
Pekkala
E
E
Ali-Melkkilä
T
T
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004381:Duodenal Ulcer / Q000150:complications / Q000401:mortality / Q000601:surgery*; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D011708:Pylorus / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013276:Stomach Ulcer / Q000150:complications / Q000401:mortality / Q000601:surgery*; D014628:Vagotomy