title: Introduction of proton pump inhibitors--consequences for surgical treatment of peptic ulcer.
abstract: OBJECTIVE
  This retrospective study analyzes the influence of different factors on morbidity and mortality after surgical treatment of peptic ulcer.
  
  
  METHODS
  At the Municipal Hospital of Offenbach, Germany, from 1985-1996, 485 patients underwent surgery.
  
  
  RESULTS
  Of the 485 patients, 70.7% (343) were diagnosed to have duodenal ulcer and 29.2% (142) had suffered from gastric ulcer. During this period, 79.2% (384) of the operations were performed under emergency conditions because of acute complications (56% of these with perforation, 20% with penetration, 24% with ulcer bleeding), whereas the rest was done electively. Two hundred and ninety-one (60%) patients were male, the average age was 59 years and 71.7% (348) of the patients had certain concomitant diseases. We observed complications in 48% of the cases with a total postoperative mortality of 21%.
  
  
  CONCLUSIONS
  Between 1985 and 1996 the total number of ulcer surgeries performed at the Municipal Hospital Offenbach per year has stayed almost constant. However, a definite increase of acute operations in addition to a decrease of elective interventions was noticed. The dissatisfying results of surgical treatment of peptic ulcer after the introduction of proton pump inhibitors seems to be the consequence of the negative selection of patients mentioned above. A connection could be proved between the age and condition of the patient, the type of the surgical intervention (acute or elective) and the morbidity and mortality after the surgery.
authors.affiliation: Department of General-, Visceral-Vascular- and Thoracic Surgery Municipal Hospital, Offenbach, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Tonus
authors.forename: E
authors.initials: E
authors.lastname: Weisenfeld
authors.forename: P
authors.initials: P
authors.lastname: Appel
authors.forename: H
authors.initials: H
authors.lastname: Nier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000897:Anti-Ulcer Agents