Recurrent bleeding and massive hemorrhage from a chronic duodenal ulcer continue to be the major indications and most serious problems in our group of patients. Massive hemorrhage, which occurs more frequently than any other type, poses the most challenging emergency situation of all complications arising from this chronic disease. The mortality from this dreaded complication is higher than that of any other type. However, the adoption of an earlier and more positive approach to the management of patients with a bleeding ulcer in recent years has resulted in a significant decrease in both morbidity and mortality rates.1-6The favorable decrease in mortality is not solely based upon the use of a new and conservative type of surgical procedure. It is due to a composite group of factors, all of which have added to making the patient more safe for the surgical procedure employed.Early and continued application of
PALUMBO LT, SHARPE WS, LULU DJ, BLOOM MH, DRAGSTEDT LR, LAWSON LJ. Distal Antrectomy With VagectomyResults in 265 Cases of Chronic Duodenal Ulcer with Hemorrhage. Arch Surg. 1964;89(4):637–644. doi:10.1001/archsurg.1964.01320040053008
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