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  • Title: [Results of the surgical treatment of gastroduodenal hemorrhage].
    Author: Demartines N, Rothenbühler JM, Chevalley JP, Harder F.
    Journal: Schweiz Med Wochenschr; 1991 Jun 01; 121(22):839-42. PubMed ID: 2063164.
    Abstract:
    383 operations for peptic ulcer were performed between 1984 and 1989. There were 114 operations for hemorrhage. The average age of patients was 65 years (21 to 90). 93% of our patients underwent preoperative endoscopy. 52.6% underwent emergency surgery whereas 47.4% had early elective operation. 91.1% of all patients underwent surgery with curative intention for peptic disease in the form of a highly selective vagotomy or partial gastrectomy. The overall mortality rate of 13.2% was influenced by age (less than 70 years: 6.5% / greater than 70 years: 20.4%), by localization of ulcer (stomach: 7%/duodenum: 16%), by time of operation (emergency: 22%/early elective: 6.3%) and by number of blood transfusions (less than 5 units: 7.7% / greater than 5 units: 21%). We conclude that bleeding gastroduodenal ulcers remain a significant complication of peptic ulcer disease. Only a multidisciplinary approach to gastroduodenal hemorrhage, including stabilization of vital functions, endoscopic hemostasis and early elective operation, will contribute to a reduction of mortality.
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