Once again we have to emphasize that this nonrandomized retrospective study only aims at validating a risk scoring system that can be used to stratify patients operated on for perforated peptic ulcers—we do not aim to compare treatment outcomes of different operative techniques. Because of its nonrandomized nature, there was a general tendency to subject "ill" patients to open repair.
Leakage after simple repair accounted for 3 of 15 deaths; all 3 patients underwent reoperation and the leakage was confirmed. For the remaining 12 patients who died of multiorgan dysfunction as a result of sepsis, postmortem examination did not reveal any evidence of leakage.
Lau WY. Predicting Mortality and Morbidity of Patients Operated on for Perforated Peptic Ulcers—Invited Response. Arch Surg. 2001;136(1):94. doi:10.1001/archsurg.136.1.94