title: Percutaneous drainage in conservative therapy for perforated gastroduodenal ulcers.
abstract: OBJECTIVE
  The management of peptic ulcers has dramatically changed and the incidence of elective surgery for gastroduodenal peptic ulcers has markedly decreased; hence, the incidence of emergency surgery for perforated peptic ulcers has slightly increased. In select cases, conservative therapy can be used as an alternative for treating perforated gastroduodenal ulcers. In this study, we evaluated the efficacy of percutaneous abdominal drainage for the conservative treatment of perforated gastroduodenal ulcers.
  
  
  METHODS
  We retrospectively studied 51 patients who had undergone conservative therapy for perforated gastroduodenal ulcers. These patients were divided into 2 groups on the basis of the initial treatment with conservative therapy with or without percutaneous drainage: group PD included patients who had undergone percutaneous drainage and group NPD, patients who had undergone non-percutaneous drainage.
  
  
  RESULTS
  In the PD group, 14.3% (n=3) of the patients did not respond to conservative therapy, while this value was 43.3% (n=13) in the NPD group. The 2 groups differed significantly with respect to conversion from conservative therapy to surgery (p<0.0352).
  
  
  CONCLUSIONS
  Conservative therapy for perforated gastroduodenal ulcers should be performed only in the case of patients meeting the required criteria; its combination with percutaneous intraperitoneal drainage is effective as initial conservative therapy.
authors.affiliation: Department of Surgery, Yokohama Central Hospital, Yokohama, Japan. ooida.takatsugu@yokochu.jp
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Oida
authors.forename: Hisao
authors.initials: H
authors.lastname: Kano
authors.forename: Kenji
authors.initials: K
authors.lastname: Mimatsu
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawasaki
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kuboi
authors.forename: Nobutada
authors.initials: N
authors.lastname: Fukino
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Kida
authors.forename: Sadao
authors.initials: S
authors.lastname: Amano
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006635:Histamine H2 Antagonists / Q000008:administration & dosage; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010437:Peptic Ulcer / Q000150:complications / Q000628:therapy*; D010439:Peptic Ulcer Perforation / Q000209:etiology / Q000628:therapy*; D054328:Proton Pump Inhibitors / Q000008:administration & dosage; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors