Commentary: Perforated giant duodenal ulcers: what is the best treatment?

Histamine receptor blockers, proton pump inhibitors, and antimicrobial therapy for Helicobacter pylori have contributed to a marked reduction in the prevalence of perforated duodenal ulcer, particularly in more economically advanced countries. When one is faced with managing a “giant” perforated ulc...

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Bibliographic Details
Published in:The American journal of surgery 2009-09, Vol.198 (3), p.324-324
Main Author: Malangoni, Mark A., M.D
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Digestive System Surgical Procedures
Duodenal Ulcer - complications
Duodenal Ulcer - surgery
Duodenostomy - methods
Female
Gastrectomy
General aspects
Helicobacter pylori
Histamine
Humans
Length of Stay - statistics & numerical data
Male
Medical sciences
Middle Aged
Omentum - transplantation
Patients
Peptic Ulcer Perforation - etiology
Peptic Ulcer Perforation - surgery
Postoperative Complications
Proton pump inhibitors
Risk Factors
Surgery
Ulcers
vagotomy
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Summary:Histamine receptor blockers, proton pump inhibitors, and antimicrobial therapy for Helicobacter pylori have contributed to a marked reduction in the prevalence of perforated duodenal ulcer, particularly in more economically advanced countries. When one is faced with managing a “giant” perforated ulcer (>2 cm), both the Graham patch and primary closure of the ulcer are less successful and a more definitive ulcer operation (eg, vagotomy with pyloroplasty or partial gastrectomy) has usually been recommended.1 In this...
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2008.12.039