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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 369 (1986), S. 741-741 
    ISSN: 1435-2451
    Keywords: Gastroduodenal ulcer ; Perforation ; Prognostic criteria ; Indication ; Gastroduodenalulcus ; Perforation ; Prognostische Kriterien ; Verfahrenswahl
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die hohe Morbidität (20–65% Ulcussymptome, 5–20% Ulcuskomplikationen, 20–39% Reoperationen) nach Excision und übernähung bei Patienten mit Ulcusperforation auchohne Ulcusanamnese spricht für die primäre, definitive Operation. Um das erhöhte Operationsrisiko auszuschalten, faßten wir 4 Risikofaktoren (Alter 〉 70, Intervall Perf./Op. 〉 24 h, schwere Begleitkrankheiten, diffuse Peritonitis) und die Ulcusanamnese 〈 3 Monate zu einem 5-Punktesystem zusammen. Patienten mit ≤ 3 Pt. wurden definitiv operiert (Excision/übernähung/PSV oder Resektion), Patienten mit ≥ 4 Pt. nur excidiert und übernäht. Die Gesamtletalität in dieser Serie von 51 Patienten (79–83) war dabei signifikant geringer (2 Patienten verstorben von 51; 4%) als in einer Serie mit grundsätzlicher definitiver Operation (5 verstorben von 64, 8%) (p 〈 0,025).
    Notes: Summary The high morbidity (20%–65% ulcer symptoms, 5%–20% ulcer complications, 20%–39% reoperations) after excision and simple closure of perforated ulcers that also occurs among patientswithout an ulcer history indicates that definitive operation is the treatment of choice. To identify patients with a high risk of mortality, a critical scoring system was devised according to whether the duration of the ulcer history exceeded 3 months and according to four risk factors: (1) age 〉 70 years, (2) time between perforation and operation 〉 24 h, (3) severe concomitant disease, and (4) diffuse peritonitis. Patients who scored ≤ 3 points underwent definitive surgery (excision, closure, proximal gastric vagotomy or partial gastrectomy), and patients who scored ≥ 4 points underwent only excision and simple closure. The overall mortality (2 of 51 patients died) of 4% was significantly lower than that of a previous group (8%) treated with definitive surgery, in which 5 of 64 patients died (p 〈 0.025).
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1435-2451
    Keywords: Proximal gastric vagotomy ; Gastroduodenal ulcer ; Ten-year results ; Proximal selektive Vagotomie ; Gastroduodenales Ulcus ; 10-Jahres-Ergebnisse
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Wir berichten über die 10-Jahres-Ergebnisse einer prospektiven multizentrischen Studie an 8 europäischen Kliniken (Basel, Bern, Düsseldorf, Erlangen, Freiburg, Krefeld, München Klinikum Grosshadern, Strassburg) zur Bewertung der proximal selektiven Vagotomie beim gastroduodenalen Ulcus. Die Nachuntersuchungsrate war 81%. Ergebnis:n symptomatisch total Visick Ulcustyp % Rezidivrate % 1 + II Ulcus duodeni524 13,6 20,4 88% Ulcus ventriculi 71 13,5 19,8 73% Ulcus pyloricum/praepyloricum 94 18,7 31,684% Kombinierte Ulcera 28 27,9 31,7 82%
    Notes: Summary We report the 10-year results of a prospective multicenter trial in eight European centers (Basel, Bern, Düsseldorf, Erlangen, Freiburg, Krefeld, München Klinikum Grosshadern, Strassburg) evaluating proximal gastric vagotomy for gastroduodenal ulcers. The follow-up rate was 81%. Results:n Symptomatic Total Visick Ulcer type recurrencerecurrence I + II (%) (%) Duodenal ulcer 524 13.6 20.488% Gastric ulcer 71 13.5 19.8 73% Pyloric/prepyloric ulcer 94 18.7 31.6 84% Combined ulcer 28 27.9 31.782%
    Type of Medium: Electronic Resource
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