Short- and long-term outcomes of surgical management of peptic ulcer complications in the era of proton pump inhibitors.
Purpose: We evaluated the short-term and long-term outcomes of emergency operations for peptic ulcer (PUD) complications in a period of time in which the need for surgery is infrequent.Methods: Retrospective review of operated patients (2007-2015) in one medical center.Results: 81 patients were incl...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 44; no. 5; pp. 795 - 802 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Oct2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=132271651&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 132271651 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Oct2018 vid: 44 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 132271651 132271651 132271651 10.1007/s00068-017-0898-z 132271651 ppf: 795 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Short- and long-term outcomes of surgical management of peptic ulcer complications in the era of proton pump inhibitors. aug: au: Hasadia, Rabea Kopelman, Yael Olsha, Oded Alfici, Ricardo Ashkenazi, Itamar affil: Hillel Yaffe Medical Center, POB 169, 38100, Hadera, Israel sug: subj: Treatment Outcomes Peptic Ulcer Surgery Postoperative Complications Proton Pump Inhibitors Therapeutic Use Emergency Service Human Retrospective Design Male Female Gastric Outlet Obstruction Surgery Gastrointestinal Hemorrhage Surgery Intestinal Perforation Surgery Recurrence Hospitalization Readmission Helicobacter Pylori Aged Aged, 80 and Over Adult Middle Age Abortifacient Agents Therapeutic Use Reoperation Gastric Acid Peptic Ulcer Drug Therapy Peptic Ulcer Mortality Gastric Outlet Obstruction Etiology Gastrointestinal Hemorrhage Etiology Intestinal Perforation Etiology Aged: 65+ years Aged, 80 & over Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Purpose: We evaluated the short-term and long-term outcomes of emergency operations for peptic ulcer (PUD) complications in a period of time in which the need for surgery is infrequent.Methods: Retrospective review of operated patients (2007-2015) in one medical center.Results: 81 patients were included (8.9 patients/year): 70 (86.4%) male; 11 (13.6%) female. Indications for operation were hemorrhage in 18 (22.2%), perforation in 62 (76.5%) and gastric-outlet obstruction in one (1.2%). Only 16 (19.8%) operations included a procedure to reduce gastric acid secretion. Six (7.4%) patients had a second operation for recurrent or persistent complication. Of these, two had a procedure to reduce gastric acid secretion in their first operation. 16 (19.8%) patients died during the index hospitalization. Three (3.7%) patients were rehospitalized for a PUD complication following 3-24 months. One patient, who had surgery for a second perforation 3 months following the first operation, was treated empirically for Helicobacter Pylori (HP) between the two operations. In comparison to perforation, patients with hemorrhage were older (69.9 ± 20.3 vs. 52.1 ± 19.9 years; p = 0.0015), more commonly had a history of PUD or treatment by nonsteroidal anti-inflammotry drugs (55.6 vs. 19.4%; p = 0.0054), more commonly had a procedure to reduce gastric acid secretion during their index operation (61.1 vs. 6.5%; p < 0.0001), and had a higher mortality (38.9 vs. 14.5%; p = 0.0406).Conclusions: Mortality is high following surgery for the complications of PUD, moreso in patients undergoing surgery for hemorrhage. Reoperations and repeated hospitalizations for complications are not uncommon, even in patients who have had procedures to reduce gastric acid secretion and HP eradication. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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