Surgeons' attitudes to the operative management of duodenal ulcer perforation and haemorrhage.
The currently preferred operative management of duodenal ulcer haemorrhage and perforation was assessed by means of a questionnaire sent to 274 consultant general surgeons in England. A 70% response rate was achieved. Simple closure, with or without H2 antagonist treatment, was the most popular management of a perforated acute duodenal ulcer. For perforation of a chronic duodenal ulcer occurring during H2 antagonist therapy, truncal vagotomy and drainage was the definitive procedure of choice. There was no consensus about the operative management of perforation complicating non-steroidal anti-inflammatory drug treatment in the elderly patient. Proximal gastric vagotomy appears to have few advocates in the definitive management of either duodenal ulcer perforation or haemorrhage. Of our sample 70% selected truncal vagotomy and drainage with underrunning of the ulcer as the operative treatment of choice for bleeding. Endoscopic coagulation appears to be used only rarely.
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002908:Chronic Disease; D003131:Combined Modality Therapy; D004381:Duodenal Ulcer / Q000150:complications*; D004739:England; D005260:Female; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010438:Peptic Ulcer Hemorrhage / Q000209:etiology / Q000601:surgery*; D010439:Peptic Ulcer Perforation / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*
D006635:Histamine H2 Antagonists