[The Taylor method in the treatment of perforated gastroduodenal ulcers: is it really obsolete?].
98 perforated gastroduodenal ulcers are studied. The overall mortality rate is low (8 per cent), but much higher in elderly, debilitated patients (42 per cent), who must undergo surgery immediately. The time elapsed between the last meal and the onset of pain between the onset of pain and admission to the hospital have no direct influence on the immediate results. These depend especially on the clinical status of the patient on admission and on the quality of repeated clinical examinations. The early criteria for necessity of surgical treatment (20 per cent) are determined; the prognosis is not worse if the operation is performed after a few hours of aspiration. Immediate success does not eliminate the risk of deferred failure (5 per cent). The aim of Taylor's method is treatment of possibly lethal perforation: treatment of the ulcer is carried out later after a complete clinical workup. "Acute" ulcers are treated medically, "chronic" ones by radical surgery. 28 out of 43 patients treated medically and followed up on the average 6 years later have a good or very good result. This study confirms the usefulness of Taylor's method in the treatment of perforated ulcers because this method is simple, and often successful (70 per cent). By Taylor's method, followed by a properly managed medical treatment, a large number of patients definitely avoid surgical treatment.
D000328:Adult; D000368:Aged; D004381:Duodenal Ulcer / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000601:surgery*; D013276:Stomach Ulcer / Q000150:complications* / Q000601:surgery
La méthode de Taylor dans le traitement des ulcères gastroduodénaux perforés: est-elle vraiment désuète?