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July 1968

Gastroduodenal Perforation: With Conclusions on the Role of Definitive Surgery

Author Affiliations

New York
From the Department of Surgery, Harlem Hospital Center, New York.

Arch Surg. 1968;97(1):96-104. doi:10.1001/archsurg.1968.01340010126014

THE THREE methods available for the treatment of acute gastroduodenal perforation are suture closure, primary gastrectomy, with or without vagotomy, and the nonoperative modality of nasogastric suction. In a previous report,1 one of us (A.L.M.) was of the opinion that selection of the appropriate procedure for each case of perforation offered more towards successful treatment and an overall reduction of mortality than rigid adherence to any one therapeutic modality for all perforation, such as suture closure which is standard procedure with the majority of surgeons.

The current report represents a continuing study of acute perforation, managed under the concept of selective therapy. A main objective is to further validate definitive surgery as acceptable therapy and to propose sound criteria for its use.

General Statistical Data  This study, from August 1959 through December 1965, covers 105 patients with acute gastroduodenal perforation, out of a total of 372 surgical admissions for

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