Galbiati E, Parenti C
Chir Ital. 1979 Oct;31(5):982-9.
The Authors considers 49 cases of perforated duodenal ulcers in free peritoneum, observed in 6 years from 1972 to 1977. They are quite exclusively males (9 : 1), aged from 22 to 80 years, observed from over 4 to 72 hours from effective perforation. After the bare necessities of their hydroelectrolitics balancing, 20 cases came to a simple suture, 29 to an ulcer excision, vagotomy and pyloric plastics. No post operative complications were noted in the two groups: mortality has been of 2 patients in the first group and of no one in the second; pathological ulcerous relaps have been of 47% in the first group and 0 in the second one, with from over 15 months to 6 years controls. By clinical, radiological and andoscopical examinations the AA, concludes that the best therapy treatment in perforated duodenal ulcers--except very particular cases--consists at the same time in the treatment of ulcerous pathology and its complications, with vagotomy completed by piloric plastics sec. Judd, and ulcer's excision.
作者回顾了1972年至1977年6年间观察到的49例十二指肠溃疡游离穿孔病例。患者几乎全为男性（9:1），年龄在22岁至80岁之间，自有效穿孔后4至72小时不等。在纠正水电解质平衡等基本处理后，20例行单纯缝合，29例行溃疡切除、迷走神经切断术及幽门成形术。两组均未出现术后并发症：第一组有2例死亡，第二组无死亡；在随访15个月至6年期间，第一组溃疡复发率为47%，第二组为0。通过临床、放射学及内镜检查，作者得出结论，除极特殊情况外，十二指肠溃疡穿孔的最佳治疗方法是同时治疗溃疡病变及其并发症，即行迷走神经切断术加Judd法幽门成形术以及溃疡切除术。
