PERFORATED DUODENAL-ULCER - SUBTOTAL ANTE RIOR LINEAR AND POSTERIOR GASTRECTOMY

Objective: To evaluate emergency surgery procedures for perforated duo denal ulcers. Methods: Emergency surgery was performed for perforated duodenal ulcers in 25 patients (19 males and 6 females) with a mean ag e of 36 +/- 15 years. The procedure consisted of simple closure follow ed by anterior and partial posterior linear gastrectomy using a stapli ng device. There were 16 patients who smoked, 11 who drank and smoked, 3 who were under treatment with noncorticosteroid anti-inflammatory a gents, 2 who had a history of other disease (myocardial infarction and arteritis) and 4 who were in septic shock Results: The delay in closu re of perforation was less than 6 hours in 17 cases. Peritoneal leakag e was confined to the supramesocolic level in 19 cases. The mean follo w-up was 14 +/- 2 months with endoscopic control at 12 months, One rec urrence (4%) was observed at 8 months. One patient died, Morbidity occ urred in 7 patients (28%): epigastric bloating in 5 cases, subphrenic abcess in 1, abcess of the stomach wall in 1 and oesophageal reflux tr eated without surgery in 1. The mean duration of hospitalization was 1 3 +/- 3 days.