MANAGEMENT OF BLEEDING GASTRIC-ULCER AND DUODENAL-ULCER - PLEADING FOR PRIMARY RESECTION UNDER EMERGENCY CONDITIONS IN ELDERLY PEOPLE

The bleeding complications of gastric- and duodenal ulcers have not de clined in the past 20 years. This is the leading factor for the unchan ged lethality of this disease. We present our results in 31 patients w ith gastroduodenal ulcer bleeding. The mean age was 72,1 years and the majority of patients had an advanced stage of ulcer disease with pene tration in neighbouring organs. 8 of 31 patients had to be operated un der emergency conditions within 6 h. 23 patients with high risk for re -bleeding were operated early elective (12-36 h); 11 of those were in a severe shock at the beginning of the operation. After control of ble eding by intra-and extraluminar ligature all patients underwent a prim ary resection (B I, B II or cardiofundectomy). The lethality was 12,9% (4/31), there was no re-bleeding. With the exception of one late duod enal insufficiency none patient had to be re-operated.