[Surgery of perforated duodenal ulcer. Treatment of the perforation or the ulcer?].

Treatment of duodenal ulcer disease with an anti-acid preparation significantly reduces early postoperative complications after simple suture of a perforation, in relation to the course of the disease. Future prognosis of the latter is unpredictable even when those parameters, normally considered as being important, are allowed for. Percentage recovery is comparable with or without cimetidine. Treatment proposed is a two-stage operative procedure: 1) treat the peritonitis; 2) conduct recovery surgery at a later stage for recurrent lesions or those resistant to medical treatment. This therapy is based on the belief that emergency conditions do not require a complicated procedure and that the latter is useless in 45% of cases, which cannot be predetermined. This attitude is reinforced by the working conditions and the increased postoperative safety after simple suture as a result of the use of cimetidine.