[Gastroduodenal ulcer disease: what surgical indications are left?]. 1989

J F Cuttat, and P Ruchat, and G Chapuis
Service de chirurgie A, Centre hospitalier universitaire vaudois, Lausanne.

Between 1976, date of the introduction of anti-H2, and 1987, 716 patients were hospitalized and operated on for ulcer disease in the surgical department of this hospital. The present study shows that 1. the annual number of operations has regressed by some 30%, 2. while the number of gastric ulcers remains constant on the whole, cases of acute duodenal ulcer have diminished by half, 3. cases of chronic, recurrent, or therapy-resistent duodenal ulcer have increased some tenfold (2 out of 78 in 1976 and 14 out of 45 in 1987), 4. the same is true of perforated ulcers (12 out of 78 in 1976 and 10 out of 45 in 1987) and hemorrhages (12 out of 78 and 10 out of 45), 5. surgery for stenosis has remained constant. -Proximal selective vagotomy has been the treatment of choice since 1981 in over 80% of duodenal ulcers. Operative mortality affects only elderly patients undergoing emergency surgery for complicated ulcer (two thirds perforations, one third hemorrhages). It is 2.6%. We thus confirm the reduced role of surgery in the treatment of gastric ulcer, while redefining the present surgical indications.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010437 Peptic Ulcer Ulcer that occurs in the regions of the GASTROINTESTINAL TRACT which come into contact with GASTRIC JUICE containing PEPSIN and GASTRIC ACID. It occurs when there are defects in the MUCOSA barrier. The common forms of peptic ulcers are associated with HELICOBACTER PYLORI and the consumption of nonsteroidal anti-inflammatory drugs (NSAIDS). Gastroduodenal Ulcer,Marginal Ulcer,Gastroduodenal Ulcers,Marginal Ulcers,Peptic Ulcers,Ulcer, Gastroduodenal,Ulcer, Marginal,Ulcer, Peptic,Ulcers, Gastroduodenal,Ulcers, Marginal,Ulcers, Peptic
D010438 Peptic Ulcer Hemorrhage Bleeding from a PEPTIC ULCER that can be located in any segment of the GASTROINTESTINAL TRACT. Hemorrhage, Peptic Ulcer,Peptic Ulcer Hemorrhages,Ulcer Hemorrhage, Peptic
D010439 Peptic Ulcer Perforation Penetration of a PEPTIC ULCER through the wall of DUODENUM or STOMACH allowing the leakage of luminal contents into the PERITONEAL CAVITY. Peptic Ulcer Perforations,Perforation, Peptic Ulcer,Perforations, Peptic Ulcer,Ulcer Perforation, Peptic,Ulcer Perforations, Peptic
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D006635 Histamine H2 Antagonists Drugs that selectively bind to but do not activate histamine H2 receptors, thereby blocking the actions of histamine. Their clinically most important action is the inhibition of acid secretion in the treatment of gastrointestinal ulcers. Smooth muscle may also be affected. Some drugs in this class have strong effects in the central nervous system, but these actions are not well understood. Antihistaminics, H2,H2 Receptor Blockader,Histamine H2 Antagonist,Histamine H2 Blocker,Histamine H2 Receptor Antagonist,Histamine H2 Receptor Antagonists,Histamine H2 Receptor Blockader,Histamine H2 Receptor Blockaders,Antagonists, Histamine H2,Blockaders, Histamine H2 Receptor,H2 Receptor Blockaders,Histamine H2 Blockers,Receptor Antagonists, Histamine H2,Receptor Blockaders, H2,Antagonist, Histamine H2,Blockader, H2 Receptor,Blockaders, H2 Receptor,Blocker, Histamine H2,Blockers, Histamine H2,H2 Antagonist, Histamine,H2 Antagonists, Histamine,H2 Antihistaminics,H2 Blocker, Histamine,H2 Blockers, Histamine,Receptor Blockader, H2
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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