Perforated benign gastric ulcer: the case for simple closure.
During the 12 years from 1975 to 1986 at University of Alberta Hospital, Edmonton, 36 patients were found to have a perforated gastric ulcer. A review of their operative treatment revealed that only one patient had a definitive gastric resection despite reports in the literature recommending the procedure. This study was undertaken to determine if simple closure was appropriate treatment for the majority of these patients. Even the enthusiasts of gastric resection would agree that advanced patient age, serious underlying disease and delay in treatment are contraindications to the procedure for perforated gastric ulcer. We found that 28 (78%) of the 36 patients had one or more of these contraindications. Thus, the high-risk nature of the patients presenting to our institution with perforated gastric ulcer explains the frequent use of simple closure in these cases. The data from this study indicate that the profile of patients presenting with perforated benign gastric ulcer needs to be defined before generalizations regarding surgical treatment are made.
Thurston
O G
OG
Department of Surgery, University of Alberta, Edmonton, Alta.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000601:surgery*; D013276:Stomach Ulcer / Q000150:complications* / Q000601:surgery