[Perforated duodenal ulcer: subtotal anterior linear and posterior tuberous gastrectomy].

OBJECTIVE

To evaluate emergency surgery procedures for perforated duodenal ulcers.

METHODS

Emergency surgery was performed for perforated duodenal ulcers in 25 patients (19 males and 6 females) with a mean age of 36 +/- 15 years. The procedure consisted of simple closure followed by anterior and partial posterior linear gastrectomy using a stapling device. There were 16 patients who smoked, 11 who drank and smoked, 3 who were under treatment with non-corticosteroid anti-inflammatory agents, 2 who had a history of other disease (myocardial infarction and arteritis) and 4 who were in septic shock.

RESULTS

The delay in closure of perforation was less than 6 hours in 17 cases. Peritoneal leakage was confined to the supramesocolic level in 19 cases. The mean follow-up was 14 +/- 2 months with endoscopic control at 12 months. One recurrence (4%) was observed at 8 months. One patient died. Morbidity occurred in 7 patients (28%); epigastric bloating in 5 cases, subphrenic abscess in 1, abscess of the stomach wall in 1 and oesophageal reflux treated without surgery in 1. The mean duration of hospitalization was 13 +/- 3 days.