Perforated gastric ulcer.
OBJECTIVE
Reports about perforated gastric ulcer are scarce and thus it is difficult to settle for a uniform model of operative management. The purpose of the study was to review our experience with perforated gastric ulcer and evaluate the results of gastric resection vs. oversewing of the perforation.


METHODS
Within 36 years 77 patients with peritonitis caused by histologically confirmed perforated gastric ulcer were operated. Furthermore, in another 7 microscopic examination revealed that perforation occurred within the gastric cancer. There were twice as many male as female patients.


RESULTS
Recently, the overall postoperative mortality (20. 8%) tended to decrease markedly. 32 patients (mean age 49.9 years) were submitted to gastric resection and this procedure was associated with 2.9% mortality. All 3 subjects in whom vagotomy, pyloroplasty and wedge resection of the ulcer had been performed survived. In 40 patients (mean age 61.5 years) only a suture of the ulcer was performed. This procedure was associated with high mortality (1/3 of patients died). Selection criteria included poor general medical status, age, comorbidities, and substantial progression of the inflammatory process.


CONCLUSIONS
Authors believe that emergency gastrectomy is a safe procedure; however, it might be performed without excessive operative risk in only half of the patients.
Wysocki
A
A
2nd Department of General Surgery, Collegium Medicum of Jagiellonian University, Krakow, Poland. msbudzyn@cyf-kr.edu.pl
Biesiada
Z
Z
Beben
P
P
Budzynski
A
A
D000328:Adult; D004638:Emergency Treatment; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000150:complications / Q000401:mortality / Q000601:surgery*; D010538:Peritonitis / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D013276:Stomach Ulcer / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016019:Survival Analysis