Medina Franco H, de la Garza Villaseñor L
Departamento de Cirugía, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.
Rev Invest Clin. 1996 Nov-Dec;48(6):437-42.
To evaluate the utility of surgery in the treatment of peptic ulcer disease.
The clinical history of patients operated for peptic ulcer disease in a 15 year period were reviewed. The demographic data, indications for surgery, surgical procedure, morbidity, mortality and long term results, were analyzed.
349 patients were operated for peptic ulcer disease or its complications, 56% male. In 78% surgery was elective, mostly due to pyloric obstruction. In the remaining 22% perforation or bleeding ulcer were the main causes for emergency surgery. The most frequent elective procedure was vagotomy and drainage (66%); in urgent surgery, a definitive procedure was done in 35% of the perforations and in 94% of the bleeding ulcers. The 30-day mortality in urgent surgery was 14%; in elective surgery there was no mortality. A satisfactory long term result was obtained in 80% of the patients.
An indication for surgical treatment of complicated peptic ulcer disease was above 50%, and 90 per cent in recent years. The frequency of urgent surgery is increasing and reached 60% of surgeries for this disease. Whenever possible, a definitive procedure is recommended.
评估手术治疗消化性溃疡疾病的效用。
回顾了15年间因消化性溃疡疾病接受手术治疗患者的临床病史。分析了人口统计学数据、手术指征、手术方式、发病率、死亡率及长期结果。
349例患者因消化性溃疡疾病或其并发症接受手术治疗，男性占56%。78%的手术为择期手术，主要原因是幽门梗阻。其余22%中，穿孔或出血性溃疡是急诊手术的主要原因。最常见的择期手术是迷走神经切断术和引流术（66%）；在急诊手术中，35%的穿孔患者和94%的出血性溃疡患者进行了确定性手术。急诊手术的30天死亡率为14%；择期手术无死亡病例。80%的患者获得了满意的长期结果。
复杂消化性溃疡疾病的手术治疗指征超过50%，近年来达到90%。急诊手术的频率在增加，占该疾病手术的60%。只要有可能，建议进行确定性手术。
