• Simple closure of a perforation in ulcerating disease of the stomach and duodenum does not influence the course of the underlying disease. Perforations develop in some cases of gastric carcinoma. The ulcer that perforated may be accompanied by bleeding ulcers elsewhere, it may be complicated by obstruction, or it may have developed at or near the stoma made in a previous operation.
In 70% or more of cases of perforation treated by simple closure, ulcers recur within five years. Treatment by immediate subtotal gastric resection, on the other hand, not only takes care of the emergency but also cures the underlying disease in more than 90% of the cases. Since subtotal resection now carries no greater risk than simple closure, it has met with increasing acceptance.
Bisgard JD. SUBTOTAL GASTRIC RESECTION FOR ACUTE PERFORATED PEPTIC ULCERS. JAMA. 1956;160(5):363–367. doi:10.1001/jama.1956.02960400021006
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