title: Simple closure or vagotomy and pyloroplasty for the treatment of a perforated duodenal ulcer: comparison of results.
abstract: OBJECTIVE
  Treatment of the perforated duodenal ulcer continues to be a controversial subject. The purpose of our study was to compare the results of simple closure of perforated duodenal ulcer versus treatment by truncal vagotomy and pyloroplasty.
  
  
  METHODS
  We present a prospective and randomized study of 207 patients who underwent surgical treatment due to perforated duodenal ulcer. In 117 patients the surgical treatment was simple closure and postsurgery medical treatment with proton pump inhibitors for 1 month, and in 90 patients vagotomy and pyloroplasty with no additional medical treatment.
  
  
  RESULTS
  We applied the Visick scale in order to compare postsurgery results. The postoperative morbidity and mortality rates were the same with both techniques. Statistically, in both cases, no significant differences were found in postsurgery symptomatology. The different rates of recurrent ulcers and the reinterventions due to recurrent ulcers presented no significant statistical values.
  
  
  CONCLUSIONS
  We conclude that simple closure remains the selected treatment in the majority of patients who present with a perforated duodenal ulcer. The operation is a simple and safe procedure.
authors.affiliation: Department of Surgery, Jerez de la Frontera University Hospital, Jerez de la Frontera, Spain. carlosgutierrez@ctv.es
authors.forename: C
authors.initials: C
authors.lastname: Gutiérrez de la Peña
authors.forename: R
authors.initials: R
authors.lastname: Márquez
authors.forename: F
authors.initials: F
authors.lastname: Fakih
authors.forename: E
authors.initials: E
authors.lastname: Domínguez-Adame
authors.forename: J
authors.initials: J
authors.lastname: Medina
mesh_terms: D000328:Adult; D000368:Aged; D004381:Duodenal Ulcer / Q000150:complications*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D054328:Proton Pump Inhibitors; D011706:Pyloric Antrum / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D016896:Treatment Outcome; D014628:Vagotomy
chemical_list: D054328:Proton Pump Inhibitors