Article Sidebar
Published:
Nov 21, 2005Article Details
Issue
Section
Articles
Material submitted for publication in the South African Medical Journal (SAMJ) is accepted provided it has not been published elsewhere. Copyright forms will be sent with acknowledgement of receipt and the SAMJ reserves copyright of the material published. The SAMJ does not hold itself responsible for statements made by the authors.
Main Article Content
Perforated gastric ulcer - reappraisal of surgical options
Abstract
Background: The available operative procedures for perforated gastric ulcer are gastrectomy, ulcer excision and omental patch closure. This study analysed the outcome of these operative options in a single institution.
Patients and methods: Seventy-two patients (mean age 43 years, 62 males) with perforated gastric ulcers were managed by laparotomy. There were 34 lesser curve (incisural) and 38 antral ulcers.
Results: Partial gastrectomy was performed in 27 patients, ulcer excision in 27 and simple patch closure in 18. Two ulcers were malignant. The mortality rate was 18% (26% for gastrectomy, 19% for ulcer excision and 5% for patch closure). Shock on admission (p=0.006) and Candida (p=0.020) in the histological specimen were predictive of poor outcome. Hospital stay was similar in the 3 groups.
Conclusion: Omental patch closure and ulcer excision are as effective as gastrectomy in the management of perforated gastric ulcer and merit consideration as first-line therapy in technically applicable cases.
South African Journal of Surgery Vol. 43(3) 2005: 58-60
Patients and methods: Seventy-two patients (mean age 43 years, 62 males) with perforated gastric ulcers were managed by laparotomy. There were 34 lesser curve (incisural) and 38 antral ulcers.
Results: Partial gastrectomy was performed in 27 patients, ulcer excision in 27 and simple patch closure in 18. Two ulcers were malignant. The mortality rate was 18% (26% for gastrectomy, 19% for ulcer excision and 5% for patch closure). Shock on admission (p=0.006) and Candida (p=0.020) in the histological specimen were predictive of poor outcome. Hospital stay was similar in the 3 groups.
Conclusion: Omental patch closure and ulcer excision are as effective as gastrectomy in the management of perforated gastric ulcer and merit consideration as first-line therapy in technically applicable cases.
South African Journal of Surgery Vol. 43(3) 2005: 58-60
