Herfarth C, Kiefhaber P
Langenbecks Arch Chir. 1978 Nov;347:573-9. doi: 10.1007/BF01579393.
The high mortality rate in bleeding of gastroduodenal ulcer is decreased by early operation or successful conservative treatment. Necessity and urgency of the operation are dependent on the individual risk factors, localization of the ulcer, intensity of bleeding, type of ulcer, and grading of the ulcerogenic lesion. The general operative procedure should be performed after emergency endoscopy: highly selective vagotomy with three vessel ligatures in duodenal ulcer, partial gastrectomy in gastric ulcer, and intensive conservative treatment in acute ulcerations. If lasercoagulation is feasible, emergency operations are dramatically reduced in favor of elective surgery.