Baekgaard N, Lawaetz O, Poulsen P E
Scand J Gastroenterol. 1979;14(1):17-20. doi: 10.3109/00365527909179841.
In the period 1959--1971 a simple operative closure was the initial management of 112 patients with acute perforation of duodenal ulcers. At follow-up 6--18 years after perforation the relevance of the length of ulcer history prior to perforation in deciding upon 'definitive' emergency operation is evaluated. Using such a selection criterion, the rate of misinterpretation at the time of perforation is close on 50%, and half of these patients would be subjected to an apparently unnecessary operation. Furthermore, about 80% of the patients for whom simple closure was not sufficient treatment developed ulcer dyspepsia within the first year after the perforation. Therefore, simple suture of a duodenal perforation with careful clinical follow-up for at least 1 year is recommended.
在1959年至1971年期间，112例十二指肠溃疡急性穿孔患者最初采用了简单的手术闭合治疗。在穿孔后6至18年的随访中，评估了穿孔前溃疡病史的长短在决定“确定性”急诊手术时的相关性。采用这样的选择标准，穿孔时的误诊率接近50%，其中一半的患者将接受明显不必要的手术。此外，对于单纯闭合治疗不足的患者，约80%在穿孔后的第一年内出现溃疡消化不良。因此，建议对十二指肠穿孔进行简单缝合，并进行至少1年的仔细临床随访。
