MORTALITY AMONG PATIENTS WITH PARTIAL GASTRECTOMY FOR BENIGN ULCER DISEASE

Partial gastrectomy for benign ulcer disease may influence future risk of death, eg, through changes in life-style or metabolism. To reveal such possible long-term effects, we analyzed a population-based cohort of 6459 patients operated on from 1950 through 1958 and followed thro ugh 1985. We found a lower overall mortality than in the general Swedi sh population (standardized mortality ratio = 0.94; 95% confidence int erval 0.91-0.97). Mortality was decreased among those with duodenal ul cers, Billroth II operations, and older age at operation but increased as time passed after operation. Mortality was significantly (P < 0.05 ) increased from tuberculosis, alcoholism, emphysema, stomach ulcer, i ntestinal obstruction, gallbladder or biliary disease, suicide, and ac cidental falls but decreased from ischemic heart disease and cerebrova scular disease. Preoperative selection of healthy patients and the pro bable increased prevalence of risk factors for ulcer disease (smoking, alcoholism, and lower socioeconomic status) in this cohort explain mo st of these findings. Apart from intestinal obstruction, gallbladder o r biliary tract diseases, and tuberculosis, the surgical procedure did not appear to increase mortality beyond one year after operation.