n South African Journal of Surgery - Perforated gastric ulcer - reappraisal of surgical options : general surgery

Volume 43, Issue 3
  • ISSN : 0038-2361
  • E-ISSN: 2078-5151



&lt;I&gt;Background.&lt;/I&gt; 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. <br><I>Patients and methods.&lt;/I&gt; 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. &lt;br&gt;&lt;I&gt;Results.&lt;/I&gt; 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 &lt;i&gt;Candida&lt;/i&gt; (p = 0.020) in the histological specimen were predictive of poor outcome. Hospital stay was similar in the 3 groups. &lt;br&gt;&lt;I&gt;Conclusion.&lt;/I&gt; 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.

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