Variations reported in surgical practice for bleeding duodenal ulcers.
BACKGROUND
To determine the current surgical management of bleeding duodenal ulcers in our program, faculty (FAC) and residents (RES) were surveyed.


METHODS
FAC (n = 33) and RES (n = 42) were surveyed regarding their surgery of choice between oversew (OS) or acid-reducing procedures (ARPs) in 4 scenarios. FAC who had recertified in general surgery (RECERT) were compared with young FAC who had not and RES (RES/young FAC). Two-group comparisons were performed.


RESULTS
Seventy-three percent of FAC and 62% of RES responded. RES perform more ARPs on hemodynamic (HD), unstable, elderly patients than FAC (P = .013). On the elderly patient, RES/young FAC perform more ARPs in a HD stable (P = .07) and unstable condition (P = .18). HD unstable patients would undergo OS more frequently than stable patients (P = .016).


CONCLUSIONS
In this survey, the choice of optimal surgical procedure for an acute bleeding ulcer varies among surgeons based on years of surgical experience and individual patient factors.
Reuben
Brian C
BC
Division of General Surgery, Department of Surgery, University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT 84132, USA. Brian.Reuben@hsc.utah.edu
Neumayer
Leigh A
LA
D000369:Aged, 80 and over; D002568:Certification; D004381:Duodenal Ulcer / Q000150:complications* / Q000601:surgery*; D005180:Faculty, Medical; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000601:surgery*; D010818:Practice Patterns, Physicians'; D011708:Pylorus / Q000601:surgery; D013536:Suture Techniques; D014628:Vagotomy