Hahnloser P, Bruttin J M, Cavin R, Petropoulos P
Helv Chir Acta. 1980 Dec;47(5):565-74.
The results of simple closure were compared with those of partial resection in the treatment of acute gastric perforation in 13 patients. Perforation was due to ulcer in 10 cases and to cancer in 3 cases. Differential diagnosis between cancer and ulcer during emergency surgery is difficult to establish and could be made in 2 cases only postoperatively. In the 8 patients undergoing gastric resection there was one fatal outcome by pulmonary embolism. In 5 patients where the perforation was only sutured, one patient aged 97 died of pneumonia. 2 patients developed severe hemorrhage and needed an emergency gastric resection, that was survived by only one patient. - Our results and those of the literature suggest that in acute gastric perforation due to ulcer or carcinoma, emergency gastric resection gives far better results than simple closure by suture.
对13例急性胃穿孔患者采用单纯缝合与部分切除术的治疗结果进行了比较。穿孔原因是溃疡10例，癌症3例。急诊手术时癌症与溃疡的鉴别诊断很难确立，仅2例在术后得以明确。接受胃切除术的8例患者中有1例因肺栓塞死亡。5例仅行穿孔缝合的患者中，1例97岁患者死于肺炎。2例发生严重出血，需要急诊行胃切除术，仅1例存活。——我们的结果及文献报道结果提示，对于溃疡或癌所致的急性胃穿孔，急诊胃切除术的效果远优于单纯缝合术。
