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May 1987

Perforated Gastric UlcersA Plea for Management by Primary Gastric Resection

Author Affiliations

From the Department of Surgery, Vanderbilt University School of Medicine, Nashville, Tenn.

Arch Surg. 1987;122(5):555-561. doi:10.1001/archsurg.1987.01400170061009

• One hundred one patients with perforated gastric ulcers have been treated at our institution during the past three decades. Ninety-one patients underwent operative repair, with a 24% mortality. A reduction in mortality and complications was realized when primary gastric resection, rather than patch closure, was performed. This could not be explained by selection bias, as risk factor prevalence was equally distributed between these two groups. We conclude that primary gastric resection, with or without vagotomy, is the procedure of choice for repair of perforated gastric ulcers. Only intraoperative hemodynamic Instability should limit operative selection to a faster, less definitive procedure.

(Arch Surg 1987;122:555-561)