Simple closure or vagotomy and pyloroplasty for the treatment of a perforated duodenal ulcer: comparison of results.

Abstract

BACKGROUND/AIMS:

Treatment of the perforated duodenal ulcer continues to be a controversial subject. The purpose of our study was to compare the results of simple closure of perforated duodenal ulcer versus treatment by truncal vagotomy and pyloroplasty.

METHODS:

We present a prospective and randomized study of 207 patients who underwent surgical treatment due to perforated duodenal ulcer. In 117 patients the surgical treatment was simple closure and postsurgery medical treatment with proton pump inhibitors for 1 month, and in 90 patients vagotomy and pyloroplasty with no additional medical treatment.

RESULTS:

We applied the Visick scale in order to compare postsurgery results. The postoperative morbidity and mortality rates were the same with both techniques. Statistically, in both cases, no significant differences were found in postsurgery symptomatology. The different rates of recurrent ulcers and the reinterventions due to recurrent ulcers presented no significant statistical values.

CONCLUSION:

We conclude that simple closure remains the selected treatment in the majority of patients who present with a perforated duodenal ulcer. The operation is a simple and safe procedure.

• Authors: C Gutiérrez de la Peña, R Márquez, F Fakih, E Domínguez-Adame, J Medina
• Journal: Digestive surgery (Dig Surg) Vol. 17 Issue 3 Pg. 225-8 ( 2000) ISSN: 0253-4886 [Print] Switzerland
• PMID: 10867454 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright 2000 S. Karger AG, Basel

Chemical References

• Proton Pump Inhibitors

Topics

• Adult
• Aged
• Duodenal Ulcer (complications)
• Female
• Humans
• Intestinal Perforation (surgery)
• Male
• Middle Aged
• Postoperative Complications
• Prospective Studies
• Proton Pump Inhibitors
• Pyloric Antrum (surgery)
• Recurrence
• Reoperation
• Treatment Outcome
• Vagotomy