Horntrich J, Keuntje H
Zentralbl Chir. 1983;108(2):65-76.
From 1969 to 1980, 1316 patients underwent surgery for gastric and duodenal ulceration. In 302 cases (23%) the indication was a vital one (158 times [12%] perforation and 144 times [11%] heavy bleeding). 1014 operations (77%) were of selective character: 1159 times partial gastrectomy, 60 times vagotomy and 97 times nonresective emergency procedures. The rate of complications following perforation was 2 1/2 times and after bleeding 3 times higher than after selective operations. The mortality rate after perforation came up to 9.5%, after hemorrhage to 13.2%, but in selective cases only to 0.6%. The total mortality rate came up to 3.0%. Our results demonstrate the fact that surgery for gastric and duodenal ulcer is mainly burdened by mortality following perforation and haemorrhage.
1969年至1980年期间,1316例患者接受了胃和十二指肠溃疡手术。其中302例(23%)的手术指征为危及生命的情况(穿孔158例[12%],大出血144例[11%])。1014例手术(77%)为选择性手术:胃部分切除术1159例,迷走神经切断术60例,非切除性急诊手术97例。穿孔后并发症发生率是选择性手术后的2.5倍,出血后并发症发生率是选择性手术后的3倍。穿孔后的死亡率达9.5%,出血后的死亡率达13.2%,但选择性手术病例的死亡率仅为0.6%。总死亡率达3.0%。我们的结果表明,胃和十二指肠溃疡手术的主要负担在于穿孔和出血后的死亡率。