Effects and indications of non-operative management for acute upper gastrointestinal perforation / 中华普通外科杂志

ABSTRACT

Objective:To evaluate the curative effect of non-surgical treatment of acute upper gastrointestinal perforation and analyze the risk factors.Methods:We retrospectively reviewed medical records of patients who were diagnosed with acute upper gastrointestinal perforation from Jan 2016 to Dec 2018 in Liaocheng People's Hospital. At first, all patients were put on non-surgical treatment. According to whether or not converted to surgery, they were divided into non-surgical treatment group (163 cases) and surgery group (29 cases). Univariate analyses and multivariate analyses were conducted.Results:192 patients with acute upper gastrointestinal perforation were cured without serious complications and death. The non-surgical treatment efficiency was 84.9%. The onset time ( OR=0.238, P=0.046), heart rate ( OR=1.043, P=0.004), serum albumin ( OR=0.869, P=0.002) are independent risk factors. Conclusion:Non-surgical treatment of acute upper gastrointestinal perforation is safe and effective. Onset time, heart rate and serum albumin are independent risk factors. In patients when time of onse t>12h, heart rate >100 beats/min, hypoalbuminemia, and high level of procalcitonin , conversion to surgery should be considered.