In this study the results of simple closure of perforated peptic ulcer
s were investigated. A total of 50% of the 84 patients operated from 1
.1.1988 to 31.12.1993 were over 60 years old. Severe comorbidity was r
eported in 80% of the patients. Most of them suffered from cardiovascu
lar diseases or malignancies. A total of 76/84 were treated by simple
closure followed by medical therapy of the ulcer. Complications occurr
ed in 58%, while the lethality rate was 26%. A total of 19/56 discharg
ed patients died within 5 years due to their comorbidity. Only 15% of
47 patients who were followed-up for 2-7 years suffered from recurrent
ulcers. We conclude that perforated peptic ulcers should be treated r
outinely by simple closure. Definitive ulcer surgery is only indicated
for patients who meet the criteria for elective ulcer surgery (when m
edical treatment is ineffective or impossible).