May 1972

Surgical Management of Peptic Ulcer Disease in the Aged Patient

Author Affiliations

Long Beach, Calif
From the departments of surgery, University of California, Irvine and the Long Beach (Calif) Veterans Administration Hospital.

Arch Surg. 1972;104(5):667-671. doi:10.1001/archsurg.1972.04180050043011

Two hundred and thirty-five patients over 60 years of age underwent operation for peptic ulcer disease. Overall mortality was 16%. Mortality increased with age, with site of ulcer, and with amount of preoperative bleeding. The primary surgical procedure had little influence on mortality. Subtotal gastrectomy was more successful than vagotomy and drainage when reoperation was required. There was a high initial mortality with suture ligature and a high recurrence rate with closure of perforation. The cause of death was recurrent hemorrhage or anastomotic leak in 24% of patients, cardiopulmonary failure in 44%, prolonged hypotension in 16%, stroke in 8%, and hepatic failure in 8%. Of 195 patients surviving operation, 75% were alive after one year and 50% were alive four years later. Only 10% of the subsequent deaths were related to ulcer disease.