[Surgery of peptic-acid disease: 1980-1994].

OBJECTIVE

To evaluate the utility of surgery in the treatment of peptic ulcer disease.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.