Variations reported in surgical practice for bleeding duodenal ulcers.

BACKGROUND

To determine the current surgical management of bleeding duodenal ulcers in our program, faculty (FAC) and residents (RES) were surveyed.

METHODS

FAC (n = 33) and RES (n = 42) were surveyed regarding their surgery of choice between oversew (OS) or acid-reducing procedures (ARPs) in 4 scenarios. FAC who had recertified in general surgery (RECERT) were compared with young FAC who had not and RES (RES/young FAC). Two-group comparisons were performed.

RESULTS

Seventy-three percent of FAC and 62% of RES responded. RES perform more ARPs on hemodynamic (HD), unstable, elderly patients than FAC (P = .013). On the elderly patient, RES/young FAC perform more ARPs in a HD stable (P = .07) and unstable condition (P = .18). HD unstable patients would undergo OS more frequently than stable patients (P = .016).

CONCLUSIONS

In this survey, the choice of optimal surgical procedure for an acute bleeding ulcer varies among surgeons based on years of surgical experience and individual patient factors.