title: [Mannheim peritonitis index as a surgical criterion for perforative duodenal ulcer].
abstract: OBJECTIVE
  to define the correlation between Mannheim peritonitis index scores and outcomes of different radical and palliative interventions for perforative duodenal ulcer.
  
  
  METHODS
  Treatment of 386 patients with perforative duodenal ulcer is presented. Different surgical techniques were analyzed including stomach resection, various methods of vagotomy with/without drainage, ulcer suturing and ulcerative edges excision with suturing in patients with Mannheim index scores <21, 21-29 and over 29. Clavien-Dindo classification was used to analyze postoperative complications.
  
  
  RESULTS
  In 64.3% of cases mortality was caused by peritonitis and peritonitis-associated complications. Surgical features resulted unfavorable outcome only in 35.7% of cases. Severe complications requiring re-operation were predominantly observed after stomach resection.
  
  
  CONCLUSIONS
  Mannheim peritonitis index is sensitive method allowing prognosis the outcomes in patients with perforative duodenal ulcer. Radical interventions are advisable in Mannheim index scores <21, in other cases palliative surgery for example suturing or edges excision with suturing is preferred. If radical surgery is performed with strict indications (Mannheim index scores <21) volume and type of surgery do not significantly influence on mortality rate.
authors.affiliation: Department of Surgery, Sechenov First Moscow State Medical University of Ministry of Health, Moscow, Russia.
authors.forename: N N
authors.initials: NN
authors.lastname: Krylov
authors.affiliation: Department of Surgery, Sechenov First Moscow State Medical University of Ministry of Health, Moscow, Russia.
authors.forename: O V
authors.initials: OV
authors.lastname: Babkin
authors.affiliation: Department of Surgery, Sechenov First Moscow State Medical University of Ministry of Health, Moscow, Russia.
authors.forename: D O
authors.initials: DO
authors.lastname: Babkin
mesh_terms: D000328:Adult; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D004381:Duodenal Ulcer / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009031:Moscow; D010043:Outcome and Process Assessment, Health Care / Q000379:methods; D018579:Patient Selection; D010439:Peptic Ulcer Perforation / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D010538:Peritonitis / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D011379:Prognosis; D012107:Research Design; D018570:Risk Assessment; D016019:Survival Analysis