[Results of the surgical treatment of gastroduodenal hemorrhage].
383 operations for peptic ulcer were performed between 1984 and 1989. There were 114 operations for hemorrhage. The average age of patients was 65 years (21 to 90). 93% of our patients underwent preoperative endoscopy. 52.6% underwent emergency surgery whereas 47.4% had early elective operation. 91.1% of all patients underwent surgery with curative intention for peptic disease in the form of a highly selective vagotomy or partial gastrectomy. The overall mortality rate of 13.2% was influenced by age (less than 70 years: 6.5% / greater than 70 years: 20.4%), by localization of ulcer (stomach: 7%/duodenum: 16%), by time of operation (emergency: 22%/early elective: 6.3%) and by number of blood transfusions (less than 5 units: 7.7% / greater than 5 units: 21%). We conclude that bleeding gastroduodenal ulcers remain a significant complication of peptic ulcer disease. Only a multidisciplinary approach to gastroduodenal hemorrhage, including stabilization of vital functions, endoscopic hemostasis and early elective operation, will contribute to a reduction of mortality.
Demartines
N
N
Département de chirurgie, Hôpital cantonal universitaire, Bâle.
Rothenbühler
J M
JM
Chevalley
J P
JP
Harder
F
F
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality / Q000601:surgery*; D010439:Peptic Ulcer Perforation / Q000601:surgery*; D012189:Retrospective Studies; D014629:Vagotomy, Proximal Gastric
Les résultats du traitement chirurgical de l'hémorragie gastro-duodénale.