Choi Yun-Suk, Heo Yoon-Seok, Yi Jin-Wook
Department of Surgery, Inha University Hospital, College of Medicine, Jung-gu, Inchon 22332, Korea.
J Clin Med. 2021 Apr 20;10(8):1790. doi: 10.3390/jcm10081790.
Perforated peptic ulcer (PPU) is a disease whose incidence is decreasing. However, PPU still requires emergency surgery. The aim of this study was to review the clinical characteristics of patients who received primary repair for PPU and identify the predisposing factors associated with severe complications.
From January 2011 to December 2020, a total of 75 patients underwent primary repair for PPU in our hospital. We reviewed the patients' data, including general characteristics and perioperative complications. Surgical complications were evaluated using the Clavien-Dindo Classification (CDC) system, with which we classified patients into the mild complication (CDC 0-III, = 61) and severe complication (CDC IV-V, = 14) groups.
Fifty patients had gastric perforation, and twenty-five patients had duodenal perforation. Among surgical complications, leakage or fistula were the most common (5/75, 6.7%), followed by wound problems (4/75, 5.3%). Of the medical complications, infection (9/75, 12%) and pulmonary disorder (7/75, 9.3%) were common. Eight patients died within thirty days after surgery (8/75, 10.7%). Liver cirrhosis was the most significant predisposing factor for severe complications (HR = 44.392, = 0.003).
PPU is still a surgically important disease that has significant mortality, above 10%. Liver cirrhosis is the most important underlying disease associated with severe complications.
穿孔性消化性溃疡（PPU）的发病率呈下降趋势。然而，PPU仍需紧急手术治疗。本研究旨在回顾接受PPU一期修复患者的临床特征，并确定与严重并发症相关的诱发因素。
2011年1月至2020年12月，我院共有75例患者接受了PPU一期修复手术。我们回顾了患者的数据，包括一般特征和围手术期并发症。手术并发症采用Clavien-Dindo分类（CDC）系统进行评估，据此将患者分为轻度并发症组（CDC 0-III，n = 61）和严重并发症组（CDC IV-V，n = 14）。
50例患者为胃穿孔，25例患者为十二指肠穿孔。手术并发症中，渗漏或瘘最为常见（5/75，6.7%），其次是伤口问题（4/75，5.3%）。医疗并发症中，感染（9/75，12%）和肺部疾病（7/75，9.3%）较为常见。8例患者在术后30天内死亡（8/75，10.7%）。肝硬化是严重并发症最重要的诱发因素（HR = 44.392，P = 0.003）。
PPU仍然是一种具有重要外科意义的疾病，死亡率超过10%。肝硬化是与严重并发症相关的最重要基础疾病。
