Zentralblatt fur Chirurgie · 1989
[Results of surgery of the hemorrhaging stomach and duodenal ulcer--a 10-year retrospective study].
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Heinz J, Kemps A, Baer U
Аннотация
Operations were performed on 131 patients for haemorrhagic peptic ulcer at Wenckebach Hospital, between 1977 and 1986. Roughly two thirds of all patients had never had ulcer before. Persistent haemorrhage was recorded from about 20 per cent of these cases by emergency gastroscopy. Immediate surgical action had to be taken on 23.7 per cent. Interval interventions were possible for 28.2 per cent, while almost 50 per cent had to be laparotomised for early recurrent bleeding. Mortality in the wake of immediate emergency operations and surgery for recurrent bleeding was nearly twice as high as that in the context of interval interventions. Resection was performed on 70 per cent, haemostasis only on 26 per cent, and additional vagotomy on 14 per cent. Overall mortality amounted to 27.5 per cent including 36.6 per cent for women and 22.8 per cent for men. Ulcer localisation had no impact on mortality. The highest mortality rate, 38.2 per cent, was recorded from patients on whom only haemostasis had been performed, while 16.7 per cent were recorded from those to whom additional vagotomy had been applied. Lethality in the context of resection amounted to 25.6 per cent. Twenty-three patients had to be relaparotomised (17.6 per cent), which pushed up the mortality rate to 43.5 per cent.