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  • Title: Acute perforated duodenal ulcer. An evaluation of surgical management.
    Author: Sawyers JL, Herrington JL, Mulherin JL, Whitehead WA, Mody B, Marsh J.
    Journal: Arch Surg; 1975 May; 110(5):527-30. PubMed ID: 1130996.
    Abstract:
    The surgical management of acute perforated duodenal ulcer has been evaluated in 360 patients. Simple closure was done in 254 patients, with a mortality of 6.7%, a morbidity of 21%, and an average hospital stay of 11.9 days. In 106 patients (29%) who underwent definitive operation for treatment of duodenal ulcer disease at time of perforation, the mortality was 2.8%, the morbidity was 15%, and the average hospital stay was nine days. Follow-up studies of simple closure in patients with no previous ulcer symptoms showed that 72% of the patients remained asymptomatic; in patients with previous ulcer symptoms, only 23% were asymptomatic. Definitive operation for acute perforation is indicated in good-risk patients who have a history of ulcers. Parietal cell vagotomy and simple closure was used in four patients with excellent early results.
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