[Perforation of duodenopyloric ulcers. Prognostic factors and therapeutic choices. Retrospective study of 140 patients]

Abstract

The treatment of perforation of duodenopyloric ulcers varies according to the risks of immediate mortality and long-term recurrence. The authors carried out a retrospective study on 140 duodenopyloric ulcers which had been treated over a 13 year period. The study high identified 3 factors of immediate mortality. Age over 70 years, admission delayed by more than 24 h and preoperative hemodynamic shock. Global mortality in this series is 8.6% and varied between 2.3% and 66.7% according to the absence or presence of these 3 risk factors, respectively. The authors recommend a simple operative protocol guided exclusively by the risk factors for mortality. The presence of a single factor requires simple suture of the perforation. Suture of the perforation and vagotomy should be performed in the absence of risk factors.