title: [Management of perforative gastroduodenal ulcer].
abstract: OBJECTIVE
  To study the immediate results of surgical treatment of patients with perforative gastroduodenal ulcer.
  
  
  METHODS
  It was analyzed immediate results of surgical treatment of 646 patients with perforative gastroduodenal ulcer. Ulcer suturing predominated as surgical technique (358 patients, 55.5%), in other observations there were different types of vagotomy (215 cases, 33.3%), partial gastrectomy in 73 (11.2%) patients.
  
  
  RESULTS
  In early postoperative period 36 (5.62%)patients died, incidence of complications was 6.2%. Following aspects effect on choice of surgical techbique including laoarotomy or minimally invasive approach, conventional suturing, vagotomy, partial gastrectomy: 1. presence of shock or unstable hemodynamics; 2. life-threating comorbidities (ASA class 3 and higher); 3. degree of abdominal bacterial contamination; 4. pre-hospital duration of disease; 5. dimension and type of ulcer; 6. ulcerative history or intraoperative evidence of chronic ulcer. Implementation or absolute predominance of surgery of the same type (suturing of perforative ulcer) leads to great number of poor long-term results (up to 60-70%) and requires repeated interventions.
authors.affiliation: Chair of Surgery, South Ural State Medical University, Health Ministry of the Russian Federation, Chelyabinsk, Russia.
authors.forename: S A
authors.initials: SA
authors.lastname: Sovtsov
mesh_terms: D019468:Disease Management; D004381:Duodenal Ulcer / Q000150:complications*; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010439:Peptic Ulcer Perforation / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D013276:Stomach Ulcer / Q000150:complications*; D014628:Vagotomy / Q000379:methods*