ACTA FAC MED NAISS 2011;28(2):95-107

Original article

UDC:616.33-002-089

Treatment of Perforative Peptic Ulcer

Ivana Đorđević, Aleksandar Zlatić, Irena Janković

Surgical Clinic, Clinical Center Niš, Serbia


SUMMARY

Perforation of peptic ulcer (PPU) is the most frequent complication of peptic ulcer disease. PPU is a serious complication which demands urgent diagnostic procedures, reanimation and surgical intervention. The aim of this study was to establish the frequency of PPU, diagnostic and therapy procedures, time and kind of surgical methods, as well as morbidity and mortality in two groups of patients. Based on the results obtained, it will be concluded if there is a statistically significant improvement in treating these patients. The paper presents a prospective-retrospective study which included patients treated at the Surgical Clinic, Clinical Center Niš, in the period 1994-2006. The patients were divided into two groups: A - examined group (2001-2006) and B - control group (1994-2000). The division was done based on the application of better and quicker diagnostic and reanimation procedures, urgent surgical treatment of secondary bacterial peritonitis (SBP) in A group patients, while such possibilities lacked in B group patients. The results of this study showed that 168 patients from the A group and 197 patients from the B group underwent the same surgical procedures, but with a significant decrease in number and severity of postoperative complications: (53.57% of patients and 91.87% of patients, respectively) (p<00001). Mortality of patients in groups A and B was 17.8% and 27.4%, respectively (p=0,042). The results on mortality obtained in the A group patients are in keeping with the literature data, which, on the other side, is not the case when discussing the ways of treating PPU, the incidence and numerous complications. This high risk group of patients demands worldly acknowledged surgical and reanimation procedures.

Key words: peptic ulcer, perforation, peritonitis