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Risk of complication in perforated duodenal ulcer operations according to the surgical technique employed.
Am Surg. 1993 May; 59(5):312-4.AS

Abstract

We prospectively analyzed a homogeneous group of 65 patients with perforated duodenal ulcer whose medical condition (no perioperative shock, no associated disease, underwent laparotomy within 12 hours after perforation, and an APACHE II score below 11) would have little effect on the outcome of surgery to study the influence of the surgical procedure (suture closure, vagotomy, or gastrectomy) on the morbidity and mortality rate. Thirty-three patients (51%) underwent vagotomy, 25 (38%) simple suture closure, and seven (11%) gastrectomy. Five patients (8%) suffered postoperative complications, two (3%) required further operation, and one (1.5%) died of pulmonary sepsis. Statistical analyses revealed that "vagotomy" presented significantly better results than did "simple suture" and "gastrectomy" that had similar results. The type of surgery, however, was not a significant risk factor in predicting complications in this sample. This study points out the need to stratify the perforated duodenal ulcer patients for accurate investigations. It also shows that definitive operations (gastrectomy or vagotomy) do not increase surgical risk in this group of patients, and, considering the poorer results with simple suture closure compared to vagotomy, the latter is an attractive option because it also treats the underlying ulcer disease.

Authors+Show Affiliations

Department of Surgery, State University of Campinas, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8489101

Citation

Rizoli, S B., et al. "Risk of Complication in Perforated Duodenal Ulcer Operations According to the Surgical Technique Employed." The American Surgeon, vol. 59, no. 5, 1993, pp. 312-4.
Rizoli SB, Neto AC, Diorio AC, et al. Risk of complication in perforated duodenal ulcer operations according to the surgical technique employed. Am Surg. 1993;59(5):312-4.
Rizoli, S. B., Neto, A. C., Diorio, A. C., Moreira, M. A., & Mantovani, M. (1993). Risk of complication in perforated duodenal ulcer operations according to the surgical technique employed. The American Surgeon, 59(5), 312-4.
Rizoli SB, et al. Risk of Complication in Perforated Duodenal Ulcer Operations According to the Surgical Technique Employed. Am Surg. 1993;59(5):312-4. PubMed PMID: 8489101.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of complication in perforated duodenal ulcer operations according to the surgical technique employed. AU - Rizoli,S B, AU - Neto,A C, AU - Diorio,A C, AU - Moreira,M A, AU - Mantovani,M, PY - 1993/5/1/pubmed PY - 1993/5/1/medline PY - 1993/5/1/entrez SP - 312 EP - 4 JF - The American surgeon JO - Am Surg VL - 59 IS - 5 N2 - We prospectively analyzed a homogeneous group of 65 patients with perforated duodenal ulcer whose medical condition (no perioperative shock, no associated disease, underwent laparotomy within 12 hours after perforation, and an APACHE II score below 11) would have little effect on the outcome of surgery to study the influence of the surgical procedure (suture closure, vagotomy, or gastrectomy) on the morbidity and mortality rate. Thirty-three patients (51%) underwent vagotomy, 25 (38%) simple suture closure, and seven (11%) gastrectomy. Five patients (8%) suffered postoperative complications, two (3%) required further operation, and one (1.5%) died of pulmonary sepsis. Statistical analyses revealed that "vagotomy" presented significantly better results than did "simple suture" and "gastrectomy" that had similar results. The type of surgery, however, was not a significant risk factor in predicting complications in this sample. This study points out the need to stratify the perforated duodenal ulcer patients for accurate investigations. It also shows that definitive operations (gastrectomy or vagotomy) do not increase surgical risk in this group of patients, and, considering the poorer results with simple suture closure compared to vagotomy, the latter is an attractive option because it also treats the underlying ulcer disease. SN - 0003-1348 UR - https://www.unboundmedicine.com/medline/citation/8489101/Risk_of_complication_in_perforated_duodenal_ulcer_operations_according_to_the_surgical_technique_employed_ DB - PRIME DP - Unbound Medicine ER -