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13. Perforation: Welche Therapie ist gesichert beim Ulcus ventriculi und Ulcus duodeni?

What treatment has been proved in perforated peptic ulcer?

  • B. Wissenschaftliches Programm
  • I. Hauptthemen mit Diskussion B. Aktuelle Fragen zur Therapie des Magen-Duodenalulcus
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Summary

Simple suture as standard treatment of perforated ulcer has been doubted because of high postoperative morbidity and reoperation-rate due to recurrent disease. Prospective studies showed that definitive surgery can decrease morbidity without increasing mortality. Selection is the important point. Patients with risk factors and perforation of acute ulcer should be treated by simple suture, patients without risk factors and perforation of chronic ulcer by definitive surgery (SPV + suture).

Zusammenfassung

Die einfache Übernähung als Standardtherapie der Ulcusperforation wurde infrage gestellt, nachdem postoperativ eine hohe Morbidität durch Ulcusrezidiv, die häufig zu Reoperationen führte, verzeichnet wurde. Prospektive Studien belegen, daß mit einer definitiven Operation die postoperative Morbidität niedrig gehalten werden kann, ohne die Letalität zu steigern. Allerdings sind Selektionskriterien wichtig. Patienten mit Risikofaktoren und ohne Ulcusanamnese sollten eher übernäht, Patienten ohne Risikofaktoren und mit chronischem Ulcus eher einer definitiven Operation durch Übernähung und SPV zugeführt werden.

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  1. Chirurgische Universitätsklinik, Langenbeckstraße 1, D-6500, Mainz

    M. Rothmund & W. Pitsch

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  1. M. Rothmund
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  2. W. Pitsch
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Rothmund, M., Pitsch, W. 13. Perforation: Welche Therapie ist gesichert beim Ulcus ventriculi und Ulcus duodeni?. Langenbecks Arch Chiv 366, 113–119 (1985). https://doi.org/10.1007/BF01836613

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  • DOI: https://doi.org/10.1007/BF01836613

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