[Perforation of duodenopyloric ulcers. Prognostic factors and therapeutic choices. Retrospective study of 140 patients].
The treatment of perforation of duodenopyloric ulcers varies according to the risks of immediate mortality and long-term recurrence. The authors carried out a retrospective study on 140 duodenopyloric ulcers which had been treated over a 13 year period. The study high identified 3 factors of immediate mortality. Age over 70 years, admission delayed by more than 24 h and preoperative hemodynamic shock. Global mortality in this series is 8.6% and varied between 2.3% and 66.7% according to the absence or presence of these 3 risk factors, respectively. The authors recommend a simple operative protocol guided exclusively by the risk factors for mortality. The presence of a single factor requires simple suture of the perforation. Suture of the perforation and vagotomy should be performed in the absence of risk factors.
Khosrovani
C
C
Clinique Chirurgicale A, Hôtel-Dieu, Nantes.
Kohen
M
M
Guiberteau
B
B
Le Neel
J C
JC
D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004381:Duodenal Ulcer / Q000150:complications / Q000401:mortality* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000150:complications / Q000401:mortality* / Q000601:surgery; D010538:Peritonitis / Q000209:etiology / Q000401:mortality* / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D013276:Stomach Ulcer / Q000150:complications / Q000401:mortality* / Q000601:surgery
Perforations des ulcères duodéno-pyloriques. Facteurs pronostiques et choix thérapeutiques. Etude rétrospective de 140 malades.